scholarly journals Systemic inflammation as a moderator between sleep and incident dementia

SLEEP ◽  
2020 ◽  
Author(s):  
Andrée-Ann Baril ◽  
Alexa S Beiser ◽  
Susan Redline ◽  
Emer R McGrath ◽  
Hugo J Aparicio ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Apnea Hypopnea Index ◽  
Arousal Index ◽  
Reactive Protein ◽  
Incident Dementia ◽  
Heart Study ◽  
Study Participants ◽  
Serum Crp

Abstract Study Objectives To determine whether C-reactive protein (CRP), a marker of systemic inflammation, moderates the association between sleep and incident dementia. Methods We studied Framingham Heart Study participants who completed at baseline a serum CRP assessment and in-home polysomnography to measure sleep duration, sleep efficiency, sleep latency, wake after sleep onset (WASO), number of awakenings, arousal index, and apnea–hypopnea index. Participants were divided into groups according to their CRP level: low (<1 mg/L), average (1–3 mg/L), and high inflammation (>3 mg/L). Surveillance for outcomes (incident all-cause and Alzheimer’s disease [AD] dementia) commenced at baseline and continued up to 22.5 years. Results In 291 participants (mean age 67.5 ± 4.9 years, 51.6% men) followed for 13.4 ± 5.4 years, we observed 43 cases of all-cause dementia, 33 of which were clinically consistent with AD. Whereas no direct association between CRP or sleep exposures was observed with incident dementia, CRP levels interacted with nighttime wakefulness when predicting both incident all-cause and AD dementia. In the high CRP group, longer WASO (hazard ratio [HR], 2.89; 95% CI, 1.31–6.34) and more nighttime awakenings (HR, 4.55; 95% CI, 1.19–17.38) were associated with higher risk of incident dementia. In the low CRP group, fewer nighttime awakenings were associated with a higher risk of incident dementia (HR, 0.07; 95% CI, 0.01–0.68). Conclusions Our findings suggest that inflammation moderates the association between sleep, particularly nighttime wakefulness, and dementia risk. The presence of inflammation may be an important determinant in evaluating how sleep disturbances relate to neurodegeneration.

Abstract MP43: Paradoxical Response to Antibodies in Periodontal Microbes in Subjects With Intracranial Atherosclerotic Stenosis

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Nishanth Kodumuri ◽  
Souvik Sen ◽  
Elizabeth A La Valley ◽  
Fareed Suri ◽  
Bruce A Wasserman ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Group Versus ◽  
Periodontal Pathogens ◽  
Atherosclerosis Risk In Communities ◽  
Paradoxical Response ◽  
Atherosclerotic Stenosis ◽  
Paradoxical Finding ◽  
Study Participants ◽  
Serum Crp ◽  
Prospective Longitudinal

Introduction: Previously we have shown that periodontal disease and systemic inflammation are related to intracranial atherosclerosis (ICAS) in Atherosclerosis Risk In Communities study (ARIC). In this study we evaluated the relationship between serum antibodies against periodontal pathogens and ICAS. Methods: In this ongoing, prospective, longitudinal community-based cohort study, participants were assessed for antibodies to periodontal organisms including Porphyrmonas gingivalis (PG), Prevotella intermedia (PI), Prevotella nigrescens (PN), Bacteriodes forsythensis (BF), Treponema denticola (TD), Actinobacillus actinomycetemcomitans (AA), Campylobacter rectus (CR), Eikenella corrodens (EC), Fusobacterium nucleatum (FN), Peptostreptococcus micros (PM), Selenomonas noxia (SN), Capnocytophaga ochracea (CO), Veillonella parvula (VP), Streptococcus sanguinis (SS), Streptococcus intermedius (SI), Streptococcus oralis (SO), Actinomycosis viscosis (AV) and Helicobacter pylori (HP). These participants underwent 3D time-of-flight magnetic resonance angiography (MRA) to evaluate ICAS. Log mean antibody (IgG), CRP and IL-6 levels were compared using t-test between groups with and without ≥50% ICAS. Results: In this ARIC cohort, 1066 participants were assessed by MRA for ICAS. Serum CRP and IL-6 data were available for all and IgG levels were available for 772 participants. The log mean IgG level was significantly lower for patients with ≥50% ICAS versus patients with <50% ICAS in four organisms: PN (1.69 vs 1.80, p= 0.03 ), BF (1.30 vs 1.38, p=0.05 ), CO (1.23 vs 1.33, p= 0.04 ), FN (0.87 vs 1.01, p=0.02 ). The log mean IgG was also lower for CR, EC, SN, VP, SI, SO and AV though not significant. Log mean CRP was higher in the ≥50% ICAS group versus the <50% ICAS group (0.58 vs. 0.47, p < 0.001 ). Log mean IL-6 levels were also higher but not significant (0. 17 vs. 0.11, p= 0.07 ). Conclusion: Higher levels of systemic inflammatory markers (CRP, IL-6) are associated with significant ICAS, but we report a significantly lower level of IgG antibodies to specific periodontal pathogens (PN, BF, CO and FN) in patients with ≥50% ICAS. This paradoxical finding may represent the effect of systemic inflammation and oxidative stress on IgG levels to periodontal bacteria.

C-reactive protein moderates the association between sleep and incident dementia: The Framingham Heart Study

2019 ◽  
Vol 64 ◽  
pp. S24
Author(s):  
A.-A. Baril ◽  
A.A. Beiser ◽  
S. Redline ◽  
E.R. McGrath ◽  
H.J. Aparicio ◽  
...  
Keyword(s):  
Framingham Heart Study ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Incident Dementia ◽  
Heart Study

scholarly journals 0879 Outcomes of Adenotonsillectomy in Children with Down Syndrome and Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A335-A335
Author(s):  
A Morello Gearhart ◽  
B Gunaratnam ◽  
E Senthilvel
Keyword(s):  
Obstructive Sleep Apnea ◽  
Down Syndrome ◽  
Sleep Apnea ◽  
Sleep Onset ◽  
Sleep Efficiency ◽  
Apnea Hypopnea Index ◽  
P Value ◽  
Children With Down Syndrome ◽  
Arousal Index ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is highly prevalent in children with Down Syndrome (DS). The aim of this study was to assess the effectiveness of adenotonsillectomy (T&A) on polysomnographic parameters of children with DS. Methods Retrospective chart review of children with DS who underwent T&A between 2012-2019 was performed. Preoperative OSA severity was categorized by obstructive apnea-hypopnea index (OAHI): mild = 1-4.9 events/h; moderate = 5-9.9 events/h; severe ≥ 10 events/h. Results We identified 43 DS children with pre and post T&A polysomnographic data in a population of 162 DS patients. A total of 25 were male, mean age 5.1 years (± 3.8 years) and 56% Caucasians. Preoperative data showed 19% mild OSA, 30% moderate and 51% severe. Postoperatively, apnea-hypopnea index (AHI) normalized in 9.3%, 37.2% had mild OSA, 18.6% moderate and 34.9% severe. Overall, T&A resulted in significant improvement (p-value &lt;0.05) in mean AHI, (18.51 ± 28.05 vs 11.72 ± 16.43), SaO2 nadir (80.00 ± 14.82 vs 85.51 ± 5.94), sleep efficiency (81.97 ± 11.15 vs 85.9 ± 8.28), arousal index (16.14 ± 10.23 vs 14.45 ± 12.34), and wake after sleep onset (67.19 ± 46.89 vs 50.55 ± 40.83) and no statistical difference (p-value &gt;0.05) in end-tidal carbon dioxide (43.86 ± 9.56 vs 44.17 ± 3.78), Rapid Eye Movement (REM)% (15.86 ± 7.75 vs 15.92 ± 7.41), sleep latency (24.03 ± 34.39 vs 22.55 ± 21.11), and central apnea index (0.86 ± 1.38 vs 0.66 ± 0.82) in pre and post T&A data. There was no statistically significant difference in pre and post T&A polysomnographic parameters between 17 DS and 17 age and gender-matched non-DS control subjects. Conclusion Adenotonsillectomy resulted in improvement in AHI, oxygen desaturation nadir, sleep efficiency, arousal index and wake after sleep onset. However, a significant portion of children with DS continued to have moderate to severe OSA after T&A. Support None.

803 Sleep Disturbances in Patients with Frontotemporal Dementia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A312-A314
Author(s):  
Nathan Walker ◽  
Bradley Vaughn
Keyword(s):  
Sleep Apnea ◽  
Frontotemporal Dementia ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Retrospective Chart Review ◽  
Sleep Efficiency ◽  
Periodic Limb Movements ◽  
Apnea Hypopnea Index

Abstract Introduction Frontotemporal dementia (FTD) is a degenerative process and,as the name implies, involves the frontal and temporal lobes of the brain. Patients with FTD make up 10–15% of all cases of dementia and 20% diagnosed before age 65, however not much is reported about sleep disturbances in these patients. Given the area of neuronal loss one would expect that sleep may be influenced early and by issues in arousal mechanisms and in breathing pattern. This study examined the polysomnography (PSG) reports of patients with a diagnosis FTD. Methods A retrospective chart review was performed to identify patients with both a diagnosis of FTD and having undergone a PSG. 23 patients were identified as fulfilling both requirements. Data recorded included, diagnosis, age at time of PSG, Epworth sleepiness scale (ESS), total sleep time (TST), wake after sleep onset (WASO), sleep latency (SL), REM sleep latency, sleep efficiency (SE), percentage of stage N1, N2, N3, and REM sleep, apnea-hypopnea index (AHI), presence of Cheyne-Stoke breathing, periodic limb movement index, and presence of REM without atonia. Results Patient age ranged from 57–85 years. Average ESS was 8.8 with only 5 patients reported excessive daytime sleepiness(as assessed by ESS). The average TST was 290 minutes, average SL was 37.9 minutes, average WASO was 147.5 minutes, and average sleep efficiency was 60.3%. Patients spent the majority of time in N2 sleep with an average of 68.3% of the time spent in N2. The average time spent in N3 was 9.6% of sleep. 8.9% of sleep was spent in REM. 83% of patients were diagnosed with sleep apnea (as defined by an AHI &gt; 5), with an average AHI of 20.2 events/hour. Cheyne-Stokes breathing was only noted in 4 of the 23 patients, or 17%. Periodic limb movements of sleep were noted in 48% of the patients (n=11). REM without atonia or RBD was not noted for any patients. Conclusion This study shows that patients with FTD suffer from typical sleep disturbances, however there is a high prevalence of sleep apnea as well as PLMS. In addition, patients with FTD have decreased sleep efficiency with increased WASO. Support (if any):

scholarly journals Serum Soluble CD163 Predicts Risk of Type 2 Diabetes in the General Population

2011 ◽  
Vol 57 (2) ◽  
pp. 291-297 ◽  
Author(s):  
Holger J Møller ◽  
Ruth Frikke-Schmidt ◽  
Søren K Moestrup ◽  
Børge G Nordestgaard ◽  
Anne Tybjærg-Hansen
Keyword(s):  
Type 2 Diabetes ◽  
General Population ◽  
Low Grade ◽  
Reactive Protein ◽  
Soluble Cd163 ◽  
Hazard Ratios ◽  
Heart Study ◽  
Increased Risk ◽  
Study Participants

BACKGROUND Activation of adipose tissue macrophages with concomitant low-grade inflammation is believed to play a central role in the development of type 2 diabetes. We tested whether a new macrophage-derived biomarker, soluble CD163 (sCD163), identifies at-risk individuals before overt disease has developed. METHODS A prospective cohort study of 8849 study participants from the general population, the Copenhagen City Heart Study, was followed for 18 years for incidence of type 2 diabetes. Risk of disease was calculated according to age- and sex-adjusted percentile categories of serum sCD163 concentrations: 0%–33%, 34%–66%, 67%–90%, 91%–95%, and 96%–100%. RESULTS A total of 568 participants developed type 2 diabetes. The cumulative incidence increased with increasing baseline sCD163 (trend P &lt; 0.001), and sCD163 was strongly associated with known risk factors such as physical inactivity, body mass index, C-reactive protein, and triglycerides (all P &lt; 0.001). Multifactorially adjusted hazard ratios for type 2 diabetes were 1.4 (95% CI, 1.0–1.9), 2.4 (1.8–3.2), 3.8 (2.6–5.5), and 5.2 (3.6–7.6) for categories 34%–66%, 67%–90%, 91%–95%, and 96%–100%, respectively, vs the 0%–33% category. In overweight men 50–70 and &gt;70 years of age, serum sCD163 concentrations in the top 5% group predicted an absolute 10-year risk of type 2 diabetes of 29% and 36% vs 7% and 8% in the lowest percentile group. Equivalent values in women were 19% and 24% vs 4% and 5%. CONCLUSIONS Increased concentrations of sCD163 predict increased risk of type 2 diabetes in the general population and may be useful for identification of high-risk overweight individuals.

scholarly journals Sleep pattern in epilepsy patients: a polysomnographic study

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Mohamed A. Tork ◽  
Hebatallah R. Rashed ◽  
Lobna Elnabil ◽  
Nahed Salah-Eldin ◽  
Naglaa Elkhayat ◽  
...  
Keyword(s):  
Sleep Disturbances ◽  
Refractory Epilepsy ◽  
Sleep Onset ◽  
The Other ◽  
Sleep Architecture ◽  
Apnea Hypopnea Index ◽  
Poor Sleep ◽  
Sleep Onset Latency ◽  
Group I ◽  
Group Ii

Abstract Background Sleep disorders and epilepsy commonly exist and affect each other. Patients with epilepsy often complain of poor sleep and on the other hand, poor sleep makes epilepsy control difficult. Objectives We aimed at comparing the sleep disturbances in a group of patients with medically controlled epilepsy versus another group with medically refractory epilepsy, from the electrophysiological standpoint. Subjects and methods Sixty epilepsy patients were included; half of them with controlled epilepsy were assigned as group I, and the other half with refractory epilepsy was assigned as group II. All patients had an overnight polysomnogram and sleep EEG done. We excluded any patient with abnormal general or neurological clinical examination. Results Patients in group II, had significantly delayed sleep onset latency and REM latency. However, higher arousal index, insomnia, and periodic limb movement index were found to be significantly higher in group I. Respiratory events; as light sleep durations, were observed to be higher in Group II, in addition to apnea-hypopnea index that was significantly higher in this group. Conclusion Epilepsy affects sleep architecture and sleep-related events. Patients with refractory epilepsy suffer from more disturbance in sleep patterns. Moreover, antiepileptic drugs can have a diverse effect on sleep architecture and quality in epileptic patients.

Short-term Effects of Intensive Periodontal Therapy on Serum Inflammatory Markers and Cholesterol

2005 ◽  
Vol 84 (3) ◽  
pp. 269-273 ◽  
Author(s):  
F. D’Aiuto ◽  
L. Nibali ◽  
M. Parkar ◽  
J. Suvan ◽  
M.S. Tonetti
Keyword(s):  
Systemic Inflammation ◽  
Inflammatory Markers ◽  
Healthy Subjects ◽  
Ldl Cholesterol ◽  
Periodontal Therapy ◽  
Reactive Protein ◽  
Cholesterol Levels ◽  
Serum Crp ◽  
The Impact ◽  
Serum Inflammatory Markers

Severe periodontitis has been associated with increased systemic inflammation. In a three-arm preliminary randomized trial, we investigated the impact of standard (SPT) and intensive periodontal therapy (IPT) on serum inflammatory markers and cholesterol levels. Medical and periodontal parameters, C-reactive protein (CRP), interleukin-6 (IL-6), total cholesterol, and LDL cholesterol were evaluated in 65 systemically healthy subjects suffering from severe generalized periodontitis. Two months after treatment, both SPT and IPT resulted in significant reductions in serum CRP compared with the untreated control (0.5 ± 0.2 mg/L for SPT, P = 0.030 and 0.8 ± 0.2 mg/L for IPT, P = 0.001). Similar results were observed for IL-6. Changes in inflammation were independent of age, gender, body mass index, and ethnicity, but a significant interaction between cigarette smoking and treatment regimen was found. The IPT group also showed a decrease in total and LDL cholesterol after 2 months. Analysis of these data indicates that periodontitis causes moderate systemic inflammation in systemically healthy subjects.

Cortical arousal frequency is increased in narcolepsy type 1

SLEEP ◽  
2020 ◽  
Author(s):  
Andreas Brink-Kjaer ◽  
Julie A E Christensen ◽  
Matteo Cesari ◽  
Emmanuel Mignot ◽  
Helge B D Sorensen ◽  
...  
Keyword(s):  
Eye Movement ◽  
Sleep Onset ◽  
Behavior Disorder ◽  
Apnea Hypopnea Index ◽  
Rapid Eye Movement ◽  
Sleep Behavior ◽  
Arousal Index ◽  
Control Subjects ◽  
Sleep Abnormalities

Abstract Study Objectives Hypocretin deficient narcolepsy (type 1, NT1) presents with multiple sleep abnormalities including sleep-onset rapid eye movement (REM) periods (SOREMPs) and sleep fragmentation. We hypothesized that cortical arousals, as scored by an automatic detector, are elevated in NT1 and narcolepsy type 2 (NT2) patients as compared to control subjects. Methods We analyzed nocturnal polysomnography (PSG) recordings from 25 NT1 patients, 20 NT2 patients, 18 clinical control subjects (CC, suspected central hypersomnia but with normal cerebrospinal (CSF) fluid hypocretin-1 (hcrt-1) levels and normal results on the multiple sleep latency test), and 37 healthy control (HC) subjects. Arousals were automatically scored using Multimodal Arousal Detector (MAD), a previously validated automatic wakefulness and arousal detector. Multiple linear regressions were used to compare arousal index (ArI) distributions across groups. Comparisons were corrected for age, sex, body-mass index, medication, apnea-hypopnea index, periodic leg movement index, and comorbid rapid eye movement sleep behavior disorder. Results NT1 was associated with an average increase in ArI of 4.02 events/h (p = 0.0246) compared to HC and CC, while no difference was found between NT2 and control groups. Additionally, a low CSF hcrt-1 level was predictive of increased ArI in all the CC, NT2, and NT1 groups. Conclusions The results further support the hypothesis that a loss of hypocretin neurons causes fragmented sleep, which can be measured as an increased ArI as scored by the MAD.

scholarly journals Quantile-dependent expressivity of serum C-reactive protein concentrations in family sets

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10914
Author(s):  
Paul T. Williams
Keyword(s):  
Acute Exercise ◽  
Postprandial Lipemia ◽  
Arterial Disease ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Heart Study ◽  
Regression Slopes ◽  
Peripheral Arterial ◽  
Serum Crp

Background “Quantile-dependent expressivity” occurs when the effect size of a genetic variant depends upon whether the phenotype (e.g., C-reactive protein, CRP) is high or low relative to its distribution. We have previously shown that the heritabilities (h2) of coffee and alcohol consumption, postprandial lipemia, lipoproteins, leptin, adiponectin, adiposity, and pulmonary function are quantile-specific. Whether CRP heritability is quantile-specific is currently unknown. Methods Serum CRP concentrations from 2,036 sibships and 6,144 offspring-parent pairs were analyzed from the Framingham Heart Study. Quantile-specific heritability from full-sib (βFS, h2 ={(1 + 8rspouseβFS)0.5 − 1}/(2rspouse)) and offspring-parent regression slopes (βOP, h2 = 2βOP/(1 + rspouse)) were estimated robustly by quantile regression with nonparametric significance determined from 1,000 bootstrap samples. Results Quantile-specific h2 (±SE) increased with increasing percentiles of the offspring’s age- and sex-adjusted CRP distribution when estimated from βOP (Ptrend = 0.0004): 0.02 ± 0.01 at the 10th, 0.04 ± 0.01 at the 25th, 0.10 ± 0.02 at the 50th, 0.20 ± 0.05 at the 75th, and 0.33 ± 0.10 at the 90th percentile, and when estimated from βFS (Ptrend = 0.0008): 0.03±0.01 at the 10th, 0.06 ± 0.02 at the 25th, 0.14 ± 0.03 at the 50th, 0.24 ± 0.05 at the 75th, and 0.53 ± 0.21 at the 90th percentile. Conclusion Heritability of serum CRP concentration is quantile-specific, which may explain or contribute to the inflated CRP differences between CRP (rs1130864, rs1205, rs1800947, rs2794521, rs3091244), FGB (rs1800787), IL-6 (rs1800795, rs1800796), IL6R (rs8192284), TNF-α (rs1800629) and APOE genotypes following CABG surgery, stroke, TIA, curative esophagectomy, intensive periodontal therapy, or acute exercise; during acute coronary syndrome or Staphylococcus aureus bacteremia; or in patients with chronic rheumatoid arthritis, diabetes, peripheral arterial disease, ankylosing spondylitis, obesity or inflammatory bowel disease or who smoke.

scholarly journals Correlation of BMI and serum albumin with c-reactive protein in male patients with stable chronic obstructive pulmonary disease

2018 ◽  
Vol 6 (9) ◽  
pp. 3147
Author(s):  
Pranab Mandal ◽  
Niranjan Sit ◽  
Abinash Agarwala ◽  
Aloke Gopal Ghoshal ◽  
Debasmita Bandyopadhyay
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Serum Albumin ◽  
Systemic Inflammation ◽  
Chronic Obstructive ◽  
P Value ◽  
C Reactive Protein ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Copd Patients ◽  
Serum Crp

Background: There is growing consensus that chronic obstructive pulmonary disease (COPD), a chronic inflammatory disease of the airways and lung parenchyma is associated with low grade systemic inflammation even in stable COPD, which increases during acute exacerbation. It is still debated whether the inflammation is a spill-over from the lung or the lung bears the share of systemic inflammation in COPD. There is systemic manifestation in COPD which is responsible for its severity in individual cases, but it is not clearly known whether the systemic inflammation give rise to systemic manifestations.Methods: In this background we measured serum C-reactive protein (CRP) level in 53 stable COPD patients and 32 age/sex matched control without known ischemic heart disease (IHD)/ diabetes mellitus (DM)/ peripheral arterial disease and normal chest X-ray and tried to find out any correlation of serum CRP level (marker of systemic inflammation) with BMI and serum albumin (marker of nutritional abnormality).Results: The study found that serum CRP level was significantly higher in stable COPD patient in comparison to healthy control. (6.226±3.9 vs 1.31±0.53).Though serum CRP level did not significantly increase with increasing severity of the disease, but serum CRP level was significantly increased in COPD patients with low BMI and low serum albumin (9.10±3.14 vs 4.01±2.90 p value <0.001 and 8.51±3.5 vs 3.59±2.5 with p value <0.001 respectively for BMI and serum albumin).Conclusions: So, the study concluded that stable COPD is associated with increased systemic inflammatory markers than normal control, correlates significantly with nutritional parameters in COPD like BMI and serum albumin level and may be an indicator of malnutrition regardless of lung function impairment.

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