TY - JOUR
T1 - Biomarkers of gut barrier dysfunction in obstructive sleep apnea
T2 - A systematic review and meta-analysis
AU - Mashaqi, Saif
AU - Rangan, Pooja
AU - Saleh, Ahlam A.
AU - Abraham, Ivo
AU - Gozal, David
AU - Quan, Stuart F.
AU - Parthasarathy, Sairam
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/6
Y1 - 2023/6
N2 - We conducted this systematic review and meta-analysis to evaluate the impact of obstructive sleep apnea (OSA) on gut barrier dysfunction as represented by the following biomarkers: zonulin, lipopolysaccharide, lipopolysaccharide binding protein, intestinal fatty acid binding protein, and lactic acid. A comprehensive search of the literature was conducted in Ovid MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov without language restrictions from inception to October 2022. The analysis of all outcomes was performed using a random-effects model. We included eight studies (seven cross sectional and one case control) in the final quantitative synthesis with a total of 897 patients. We concluded that OSA was associated with higher levels of gut barrier dysfunction biomarkers [Hedges’ g = 0.73 (95%CI 0.37–1.09, p < 0.01). Biomarker levels were positively correlated with the apnea-hypopnea index [r = 0.48 (95%CI 0.35–0.6, p < 0.01)] and oxygen desaturation index [r = 0.30 (95%CI 0.17–0.42, p < 0.01)], and negatively correlated with the nadir oxygen desaturation values [r = −0.45 (95%CI - 0.55 – - 0.32, p < 0.01). Our systematic review and meta-analysis suggests that OSA is associated with gut barrier dysfunction. Furthermore, OSA severity appears to be correlated with higher biomarkers of gut barrier dysfunction. Prospero registration number: CRD42022333078.
AB - We conducted this systematic review and meta-analysis to evaluate the impact of obstructive sleep apnea (OSA) on gut barrier dysfunction as represented by the following biomarkers: zonulin, lipopolysaccharide, lipopolysaccharide binding protein, intestinal fatty acid binding protein, and lactic acid. A comprehensive search of the literature was conducted in Ovid MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov without language restrictions from inception to October 2022. The analysis of all outcomes was performed using a random-effects model. We included eight studies (seven cross sectional and one case control) in the final quantitative synthesis with a total of 897 patients. We concluded that OSA was associated with higher levels of gut barrier dysfunction biomarkers [Hedges’ g = 0.73 (95%CI 0.37–1.09, p < 0.01). Biomarker levels were positively correlated with the apnea-hypopnea index [r = 0.48 (95%CI 0.35–0.6, p < 0.01)] and oxygen desaturation index [r = 0.30 (95%CI 0.17–0.42, p < 0.01)], and negatively correlated with the nadir oxygen desaturation values [r = −0.45 (95%CI - 0.55 – - 0.32, p < 0.01). Our systematic review and meta-analysis suggests that OSA is associated with gut barrier dysfunction. Furthermore, OSA severity appears to be correlated with higher biomarkers of gut barrier dysfunction. Prospero registration number: CRD42022333078.
KW - Apnea-hypopnea index
KW - Biomarkers
KW - Gut barrier dysfunction
KW - Nadir SpO2
KW - Obstructive sleep apnea
KW - Oxygen desaturation index
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U2 - 10.1016/j.smrv.2023.101774
DO - 10.1016/j.smrv.2023.101774
M3 - Review article
C2 - 37028145
AN - SCOPUS:85151498306
SN - 1087-0792
VL - 69
JO - Sleep Medicine Reviews
JF - Sleep Medicine Reviews
M1 - 101774
ER -