Ali Nihat Annakkaya

Reduced plasma fetuin-A levels in patients with obstructive sleep apnoea

To the Editors: Obstructive sleep apnoea syndrome (OSAS) has been increasingly linked to cardiovascular disease. fetuin-A is an inhibitor of vascular calcification and an anti-inflammatory cytokine. We tested the hypothesis that plasma levels of fetuin-A are decreased in patients with OSAS. We studied 119 patients with OSAS and 35 controls. Participants were recruited and studied at the sleep unit at Hospital Universitari Son Espases, Palma de Mallorca, Spain. Serum levels of fetuin-A, glucose, triglycerides, cholesterol, high-density lipoprotein (HDL) cholesterol, creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) were determined. Plasma fetuin-A levels were significantly lower in patients with OSAS than in controls (mean±sd 368±66 versus 445±53 ng·mL−1, p=0.015). In multivariate analysis, fetuin-A levels were independently associated with OSAS (p=0.034). OSAS is associated with reduced levels of fetuin-A and fetuin-A could be one of the contributing factors for the development of cardiovascular complications in OSAS patients. There is evidence that patients with OSAS have an increased risk for cardiovascular diseases [1]. The mechanisms underlying this association are unclear but candidate mechanisms include endothelial dysfunction, oxidative stress, systemic inflammation and metabolic dysregulation [2]. Vascular calcification has recently received much attention because of its relationship with cardiovascular disease [3, 4]. Chronic inflammation may promote vascular calcification and recent studies have demonstrated a relationship between vascular calcification and endothelial dysfunction [5, 6]. Fetuin-A is a circulating protein mostly synthesised in the liver [7, 8] that is known to be an important inhibitor of vascular calcification and a potent anti-inflammatory cytokine [8–10]. Fetuin-A is considered to be a mediator that links chronic inflammation to cardiovascular diseases [11]. However, previous studies investigating the role of fetuin-A in patients with cardiovascular disease …

Acute Lung Injury- ARDS in H1N1: Timing of Therapy

In some viral or bacterial infections, a minority of patients developed rapidly progressive pneumonia leading to acute lung injury (ALI)-acute respiratory distress syndrome (ARDS).