Oxidative Stress Biomarkers and Their Association with Interleukin-6 in Patients with Obstructive Sleep Apnea: A Cross-Sectional Study

Role of Heme Oxygenase-1 (HO-1) in the Pathogenesis of Hypertension among Young Adults: Association with Oxidative Stress, Inflammatory Markers, and Metabolic Profile

Hypertension in young adults is increasingly recognized as a multifactorial condition associated with oxidative stress, inflammation, endothelial dysfunction, and metabolic imbalance. This study investigated the relationship between heme oxygenase-1 (HO-1) and hypertension among young adults, with particular attention to oxidative stress markers, inflammatory mediators, and metabolic profiles. A case–control study was conducted involving 170 hypertensive and normotensive participants. Sociodemographic and clinical characteristics were assessed alongside blood pressure, body mass index (BMI), body weight, and biochemical markers, including HO-1, vascular endothelial growth factor (VEGF), insulin, nitric oxide (NO), iron, and adenosine deaminase (ADA). Compared with normotensive controls, hypertensive participants had significantly higher systolic and diastolic blood pressure (p < 0.05), as well as higher BMI and body weight. HO-1 concentrations were markedly lower in hypertensive participants (p < 0.00001), indicating reduced antioxidant capacity. Conversely, VEGF concentrations were significantly elevated (p < 0.00001), consistent with altered vascular regulation. Hypertensive participants also exhibited increased insulin concentrations (p < 0.01), reduced NO concentrations (p < 0.00001), and elevated iron and ADA concentrations (p < 0.00001), collectively reflecting metabolic dysregulation, impaired endothelial function, oxidative stress, and inflammatory activity. Correlation analysis revealed no significant associations between HO-1 and adenosine, ADA, or xanthine oxidase (p > 0.05). These findings identify a distinct biochemical profile of young-adult hypertension characterized by reduced HO-1 and NO concentrations alongside increased VEGF, insulin, iron, and ADA concentrations. Although the case–control design does not establish causality, the results highlight HO-1 as a relevant component of the oxidative and vascular alterations associated with hypertension and support further longitudinal and mechanistic investigation.

Association of inflammation-related biomarkers with the risk of obstructive sleep apnea among senior adults: a prospective cohort study.

OBJECTIVE This study aimed to examine the association between six common inflammation-related biomarkers and obstructive sleep apnea (OSA) incidence in a prospective cohort. METHODS 2,633 participants aged ≥60 years and without OSA were selected from the baseline survey of Guangzhou Heart Study, conducted in 2015-2017. The follow-up survey was conducted in 2018-2019. OSA was evaluated using Berlin Questionnaire in each survey. Six inflammation-related biomarkers, including uric acid, C-reactive protein (CRP), bilirubin, systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), were detected or calculated. Odds ratio (OR) with a 95% confidence interval (CI) was estimated using logistic regression model. RESULTS 379 (14.4%) new cases of OSA were identified during a median of 31.13 months of follow-up. When comparing the highest and lowest quartiles, bilirubin was associated with a 38% increased risk of OSA (OR: 1.43, 95% CI: 1.04 - 1.96) after adjustment for potential confounders. In stratified analysis, when comparing the highest with lowest quartiles and after adjustment for confounders, bilirubin was associated with 1.71-fold (95% CI: 1.15 - 2.53) risk of OSA among females and 1.57-fold (95% CI: 1.02 - 2.42) risk of OSA among the older aged more than 68 years, and CRP was associated with 2.61-fold (95% CI: 1.29 - 5.32) risk of OSA among males. No significant association was found between other four biomarkers and OSA risk. CONCLUSIONS A higher level of serum bilirubin was associated with an increased risk of OSA. Bilirubin may be a biomarker for precise prevention and treatment of OSA.

Serum hypoxia-inducible factors, heat shock proteins, and mitochondrial biomarkers in relation to neurocognitive performance in obstructive sleep apnea: a cross-sectional study.

STUDY OBJECTIVES Obstructive sleep apnea(OSA) is linked to impaired cognitive functions through a variety of underlying mechanisms. We investigated possible hypoxic, inflammatory and mitochondrial mediators of cognitive dysfunction in OSA. METHODS We prospectively enrolled 146 adult patients with OSA and 103 healthy controls. We analyzed demographic and clinical data, neurocognitive assessments by a set of cognitive batteries(Montreal Cognitive Assessment[MoCA], Digit Span Test[backward/forward], and Stroop test), and full night polysomnography(PSG) recordings. We also analyzed biochemical parameters including hypoxia-induced factors(HIF-1α,HIF-2α), interleukin-6, tumor necrosis factor-alpha(TNF-α), alpha-enolase(Eno1), and members of heat shock proteins-70 family(HspA1A,HspA8) by the ELISA method. mtDNA copy number was measured and mRNA expressions of peroxisome proliferator-activated receptor gamma coactivator-1-alpha(PGC-1α) and mitochondrial transcription factor-A(TFAM) were determined. RESULTS Mean age was similar between groups, while male-to-female ratio and body mass index(BMI) were significantly higher in patients with OSA, for which all statistical analyses were corrected. We observed positive correlations between HIF-1α and average time/number of errors in Stroop test; Eno1 and number of errors in Stroop test; HSPA1A and average time in Stroop test; mtDNA copy number and numbers in DST-backward. Negative correlations were observed between HIF-2α and MoCA; TNF-α and number of errors in Stroop test; Eno1 and numbers in DST-backward; HSPA1A and MoCA. Of PSG parameters, WASO negatively correlated with mtDNA copy number; duration of REM-sleep positively correlated with PPARGC1A-mRNA expressions; apnea-hypopnea index negatively correlated with HIF-1α. CONCLUSIONS Our results demonstrated complex and important correlations between neurocognitive assessments and mediators of hypoxia, inflammation, protein misfolding, and mitochondrial trafficking, which may serve as biochemical biomarkers of cognitive impairment in OSA.

Prognostic Significance of Oxidative Stress Biomarkers and Novel Hematological Inflammatory Indices in Colorectal Cancer: A Prospective Observational Study

CRC was associated with increased circulating oxidative stress biomarkers, with MDA showing the most consistent relationships with systemic inflammatory parameters and survival outcomes, and MDA is identified as a promising candidate oxidative–inflammatory marker warranting external validation rather than an independently established prognostic biomarker.

Linking disease severity and mortality in obstructive sleep apnea: the role of the endothelial activation and stress index.

Association between the C-reactive protein–triglyceride-glucose index and obstructive sleep apnea risk

Obstructive sleep apnea (OSA) is characterized by intermittent hypoxia, fragmented sleep, and heightened sympathetic activity, drivers of oxidative stress, systemic inflammation, and metabolic dysregulation. The C-reactive protein–triglyceride-glucose index (CTI) has recently emerged as a composite marker of inflammatory and metabolic states. This study aimed to investigate the association between the CTI index and OSA risk in a nationally representative United States adult population. We analyzed data from 4564 participants in the 2015 to 2018 National Health and Nutrition Examination Survey. Logistic regression, restricted cubic spline modeling, and subgroup analyses were performed to examine the association between CTI and OSA risk. Predictive performance of CTI was compared with triglyceride-glucose and C-reactive protein using receiver operating characteristic curves. Mediation analysis assessed the role of body mass index (BMI). Higher CTI was positively associated with increased OSA risk, and no significant evidence of nonlinearity was observed (P for nonlinear = .424). Each unit increase in CTI corresponded to a 43% higher odds of OSA, and those in the highest quartile had over twice the odds compared with the lowest. CTI showed slightly higher discriminatory ability than the TyG index and CRP, although its overall discriminative performance remained modest. BMI statistically mediated 56.3% of the observed association. Findings were consistent across subgroups. CTI was independently associated with OSA among United States adults, with BMI accounting for a substantial proportion of this association. As a readily available biomarker integrating inflammatory and metabolic information, CTI may provide additional value for OSA risk assessment.