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Serum homocysteine in obstructive sleep apnea syndrome can be lowered by CPAP-therapy
Obstructive sleep apnea patients (OSA) with ischemic heart disease or stroke have elevated plasma homocysteine levels, but serum total homocysteine (tHcy) concentrations in patients without severe cardio-/cerebrovascular pathology or the influence of treatment are unknown.
Therefore, serum tHcy and compounds of Hcy-metabolism were measured in untreated OSA patients and followed up during CPAP-treatment. Blood samples were taken in the evening, twice during sleep, in the morning, and one hour after awakening.
THcy levels in OSA followed a circadian pattern which was preserved under treatment. Two patients showed levels above 15µmol/l. Overall tHcy levels in patients were lowered about 30% by CPAP-treatment.
Dietary changes might contribute to the daily tHcy-variation, but an independent circadian rhythm cannot be excluded. The significant tHcy-reduction under treatment suggests that repeated apnea-related hypoxic events, e.g. oxidative stress, may enhance tHcy. CPAP-therapy is effective to lower tHcy and thus the increased (hyper)homocysteinemia-related risk for cardio-/cerebrovascular diseases.