The effect of isolated nocturnal oxygen desaturations on serum hs-CRP and IL-6 in patients with chronic obstructive pulmonary disease

摘要

Introduction A majority of patients with chronic obstructive pulmonary disease (COPD) die of cardiovascular disease (CVD), yet the mechanisms responsible for this association are not fully understood. It remains unknown if isolated nocturnal oxygen desaturation (iNOD) could be one of the potential pathways by which the 'inflammatory COPD' phenotype leads to CVD. Objectives We aimed to evaluate if COPD patients who meet the Medicare guidelines for nocturnal oxygen therapy (iNOT+) had higher serum hs-CRP and IL-6 than those who did not meet the guidelines for iNOT (iNOT-). Methods Patients with moderate to severe COPD (ie FEV1 80% and FEV1/FVC 70), who were not on oxygen, underwent nocturnal oximetry on room air. Serum IL-6 and hs-CRP were collected the morning after the nocturnal oximetry testing. Results A total of 28 patients were included in the study, 8 of whom had more than 5 minutes and 5% of their sleep time spent at oxygen saturation less than 88% and constituted the iNOT+ group. Only serum hs-CRP was significantly higher in iNOT+ than iNOT- (P = 0.050). There was no difference in the rate of COPD exacerbations at one and three months, or five-year survival between the groups (P 0.3). Conclusion COPD patients who have more than 5 minutes and 5% of their sleep time spent at oxygen saturation less than 88% have increased hs-CRP, which is associated with increased risk of future CVD.