Journal Information
Vol. 42. Issue 10.
Pages 492-500 (October 2006)
Share
Share
Download PDF
More article options
Vol. 42. Issue 10.
Pages 492-500 (October 2006)
Original Articles
Full text access
Blood Uric Acid Levels in Patients With Sleep-Disordered Breathing
Visits
5726
Aránzazu Ruiz García
Corresponding author
arevello@telefonica.net

Correspondence: Dra. A. Ruiz García. Mairena, 46, bloque 2, bajo 7. 41500 Alcalá de Guadaira. Sevilla. España
, Ángeles Sánchez Armengol, Estefanía Luque Crespo, Domingo García Aguilar, Auxiliadora Romero Falcön, Carmen Carmona Bernal, Francisco Capote
Unidad de Trastornos Respiratorios del Sueño, Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospitales Universitarios Virgen del Rocío, Sevilla, España
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Objective

Recurrent hypoxia associated with sleep apnea-hypopnea syndrome (SAHS) leads to an increase in the degradation of adenosine triphosphatase to xanthine and, secondarily, to an increase in uric acid concentrations. The aim of the present study was to determine whether there is a correlation between uric acid levels in peripheral blood and sleep-disordered breathing, independently of known confounding factors.

Patients and methods

We carried out a retrospective cross-sectional study of 1135 patients evaluated for suspected SAHS. For all patients, a medical history was taken using a standardized protocol. In addition, biochemical analysis of venous blood and an overnight sleep study (with either conventional polysomnography or home monitoring) were carried out.

Results

The mean (SD) concentration of uric acid was 631 (1.5) mg/dL, and 36% of patients had concentrations above established normal values for their sex. We found a significant correlation between uric acid levels and some steep study parameters (number of respiratory events, number of desaturations, or the percentage of time with oxygen saturation less than 90%). Those patients with more respiratory events (apnea-bypopnea index or respiratory event index ≥30) had higher uric acid levels than those with mild or no SAHS. However, this difference was not apparent in the univariate analysis of variance, in which body mass index and cholesterol and triglyceride levels were considered confounding factors.

Conclusions

Uric acid levels are positively correlated with the number of obstructive respiratory episodes and oxygen desaturations during sleep, but this correlation seems to be influenced bv other factors, such as obesitv.

Key words:
Sleep apnea-hypopnea syndrome
Uric acid
Diagnosis
Objetivo

La hipoxia recurrente del si'ndrome de apnea-hipopnea durante el sueno (SAHS) origina un aumento de la degradatión de adenosintrifosfato a xantina y, secundariamente, de las concentraciones de ácido úrico. El propósito del presente estudio ha sido analizar si existe relatión entre los valores de ácido úrico en sangre periférica y los trastornos respiratorios durante el sueño, independientemente de los factores de confusión conocidos.

Pacientes y métodos

Se ha realizado un estudio transversal retrospectivo con 1.135 pacientes evaluados por sospecha de SAHS. A todos ellos se les realizaron una historia clínica protocolizada, un estudio bioquímico de sangre venosa y un estudio de sueño nocturno (polisomnografía conventional o poligrafía domiciliaria).

Resultados

El valor medio (± desviación estándar) del ácido úrico fue de 6,31 ± 1,5 mg/dl, y el 36% de los pacientes presentaban unas concentraciones de uricemia superiores a les establecidas como normales según el sexo. Encontramos una correlatión significativa entre los valores de ácido úrico y algunos parámctros de los estudios de sueño (número de eventos respiratorios, número de desaturaciones o el porcentaje de registro con saturatión < 90%). Los pacientes con mayor número de eventos respiratorios (índice de apneas-hipopneas o índice de eventos respiratorios ≥ 30) tenían un valor más alto de ácido úrico que aquéllos sin SAHS o con SAHS leve, aunque esta diferencia desapareció al realizar un análisis de la variancia univariante en el que se consideraron factores de confusión el índice de masa corporal y los valores de colesterol y triglicéridos.

Conclusiones

Los valores de uricemia aumentan a medida que lo hacen los episodios respiratorios obstructives y las desaturaciones durante el sueño, pero este aumento parece condicionado por varios factores, como la obesidad.

Palabras clave:
Síndrome de apnea-hipopnea durante el sueño (SAHS)
Ácido úrico
Diagnóstico
Full text is only aviable in PDF
REFERENCES
[1]
JD Lin, WK Chiou, HF Weng, JT Fang, TH Liu.
Application of three-dimensional body scanner: observation of prevalence of metabolic syndrome.
Clin Nutr, 23 (2004), pp. 1313-1323
[2]
AS Jubber.
Respiratory complications of obesity.
Int J Clin Pract, 58 (2004), pp. 573-580
[3]
F Nieto, T Young, B Lind.
Association of sleep-disordered breathing, sleep apnea and hypertension in a large community-based study: Sleep Heart Health Study.
JAMA, 283 (2000), pp. 1829-1836
[4]
P Peppard, T Young, M Palta, J Skatrud.
Prospective study of the association between sleep-disordered breathing and hypertension.
N Engl J Med, 342 (2000), pp. 1378-1384
[5]
A Braghiroli, C Sacco, M Erbetta, V Ruga, CF Donner.
Overnight urinary acid: creatinine ratio for detection of sleep hypoxemia. Validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treatment with nasal continuous positive airway pressure.
Am Rev Respir Dis, 148 (1993), pp. 173-178
[6]
JD Hasday, CM Grum.
Nocturnal increase of urinary uric acid: creatinine ratio. A biochemical correlate of sleep-associated hypoxemia.
Am Rev Respir Dis, 135 (1987), pp. 534-538
[7]
H Sahebjani.
Changes in urinary uric acid excretion in obstructive sleep apnea before and after therapy with nasal continuous positive airway pressure.
Chest, 113 (1998), pp. 1604-1608
[8]
JL Keon, NA Saunders, K Murree-Allen, LG Olson, S Gyulay, J Dickeson, et al.
Urinary uric acid: creatinine ratio, serum erythropoietin, and blood 2,3-diphosphoglycerate in patients with obstructive sleep apnea.
Am Rev Respir Dis, 142 (1990), pp. 8-13
[9]
American Sleep Disorders Association.
Sleep disorders atlas task force. EEG arousals: scoring rules and examples.
Sleep, 15 (1992), pp. 173-184
[10]
F Leyva, SD Anker, IF Godsland, M Teixeira, PG Hellewell, WJ Kox, et al.
Uric acid in chronic heart failure: a marker of chronic inflammation.
Eur Heart J, 19 (1998), pp. 814-822
[11]
F Leyva, TP Chua, SD Anker, AJ Coats.
Uric acid in chronic heart failure: a measure of the anaerobic threshold.
Metabolism, 47 (1998), pp. 1156-1159
[12]
X Busquets, F Barbé, A Barceló, M de la Pena, N Sigritz, LR Mayoralas, et al.
Decreased plasma levels of orexin-A in sleep apnea.
Respiration, 71 (2004), pp. 575-579
[13]
A Barceló, F Barbé, E Llompart, M de la Pena, J Durán-Cantolla, A Ladaria, et al.
Neuropeptide Y and leptin in patients with obstructive sleep apnea syndrome: role of obesity.
Am J Respir Crit Care Med, 171 (2005), pp. 183-187
[14]
K Tatsumi, Y Kasahara, K Kurosu, N Tanabe, Y Takiguchi, T Kuriyama.
Sleep oxygen desaturation and circulating leptin in obstructive sleep apnea-hypopnea syndrome.
Chest, 127 (2005), pp. 716-721
[15]
J Durán, S Esnaola, R Ramón, A Iztueta.
Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 years.
Am J Respir Crit Care Med, 163 (2001), pp. 608-613
[16]
BF Culleton, MG Larson, WB Kannel, D Levy.
Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study.
Ann Intern Med, 131 (1999), pp. 7-13
[17]
CA Kushida, B Efron, C Guilleminault.
A predictive morphometric model for the obstructive sleep apnea syndrome.
Ann Intern Med, 127 (1997), pp. 581-587
[18]
DO Rodenstein.
Trastornos respiratorios con pulmón sano.
Medicina interna,
[19]
K Nagahama, K Iseki, T Inoue, T Touma, Y Ikemiya, S Takishita.
Hyperuricemia and cardiovascular risk factor clustering in a screened cohort in Okinawa, Japan.
Hypertens Res, 27 (2004), pp. 227-233
[20]
D Corella, J Silla, JM Ordovas, A Sabater, S Ruiz de la Fuente, O Potoles, et al.
Asociación entre el ácido únco sérico y otros factores de rieseo cardiovascular en población laboral masculina de Valencia.
Rev Clin Esp, 199 (1999), pp. 806-812
[21]
D Conen, V Wietlisbach, P Bovet, C Shamlaye, W Riesen, F Paccaud, et al.
Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country.
BMC Public Health, 25 (2004), pp. 4-9
[22]
C Guilleminault, M Quera-Salva, M Partinen, A Jamieson.
Women and the obstructive sleep apnea syndrome.
Chest, 93 (1998), pp. 104-109
[23]
E Quintana-Gallego, C Carmona-Bernal, F Capote, A Sánchez-Armengol, G Botebol-Benhamou, J Polo-Padillo, et al.
Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients.
Respir Med, 98 (2004), pp. 984-989
[24]
KL Wallace, AA Riedel, N Joseph-Ridge, R Wortmann.
Increasing prevalence of gout and hyperuricemia over 10 years among older adults in a managed care population.
J Rheumatol, 31 (2004), pp. 1582-1587
[25]
MY Desai, RD Santos, D Dalal, JA Carvalho, DR Martin, JA Flynn, et al.
Relation of serum uric acid with metabolic risk factors in asymptomatic middle-aged Brazilian men.
Am J Cardiol, 9 (2005), pp. 865-868
[26]
T Young, M Palta, J Dempsey, S Weber, S Badr.
The occurrence of sleep disordered breathing among middle aged adults.
N Engl J Med, 328 (1993), pp. 1230-1236
[27]
J Durán-Cantolla, J Mar, G de la Torre Muñecas, R Rubio Aramendi, L Guerra.
El síndrome de apneas-hipopneas durante el sueño en-España. Disponibilidad de recursos para su diagnóstico y tratamiento en los hospitales del Estado español.
Arch Bronconeumol, 40 (2004), pp. 259-267
[28]
F Capote, JF Masa, A Jiménez, G Peces-Barba, J Amilibia, R Rubio.
Manifestaciones clínicas del SAHS. Métodos diagnósticos. Síndrome de resistencia aumentada de la vía aérea superior.
Arch Bronconeumol, 38 (2002), pp. 21-27
[29]
SD Ross, IA Sheinhait, KJ Harrison, M Kvasz, JE Connelly, SA Shea, et al.
Systematic review and meta-analysis of the literature regarding the diagnosis of sleep apnea.
Sleep, 23 (2000), pp. 519-532
[30]
F Barbé, J Amilibia, F Capote, J Durán, N Mangado, A Jiménez, et al.
Diagnóstico del síndrome de apneas obstructives durante el sueño. Informe de consenso del Área de Insuficiencia Respiratoria y Trastornos del sueño.
Arch Bronconeumol, 31 (1995), pp. 460-462
[31]
American Academy of Sleep Medicine Task Force.
Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research.
Sleep, 22 (1999), pp. 667-689
Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?