Reactive oxygen metabolites (ROMs) as an index of oxidative stress in obstructive sleep apnea patients

STUDY OBJECTIVES: Obstructive sleep apnea syndrome (OSA) is accompanied by oxygen desaturation and arousal from sleep. Free oxygen radicals are highly reactive molecules which could be produced by the OSA phenomenon of hypoxia/reoxygenation: cyclical alterations of arterial oxygen saturation with oxygen desaturation developing in response to apneas followed by resumption of oxygen saturation during hyperventilation. On the basis of these considerations, it was hypothesized that OSA may be linked to increased oxidative stress. MATERIAL AND METHODS: Twenty-six participants gave an interview during which a physician asked them about their age, smoking habits, and symptoms such as excessive daytime sleepiness and snoring. Physical examination and polysomnography were performed during their hospitalization. Reactive oxygen metabolites (ROMs) were measured in blood samples by the diacron reactive oxygen metabolites (D-ROM) test. RESULTS: Twenty-one out of 26 subjects had an apnea/hypopnea index greater than 5 (OSA group). The measurement of free radicals was high in OSA patients. Furthermore, ROMs values in OSA patients were linearly correlated with the apnea/hypopnea index (R = 0.426; p = 0.042). The predictive value of a positive D-ROM test is 81%. CONCLUSIONS: ROMs were elevated in patients with OSA. When OSA was severe, similarly the value of ROMs in blood samples was enhanced, and the probable underlying mechanism for these events is the hypoxia/reoxygenation phenomenon

Global initiative for chronic obstructive lung disease for chronic obstructive pulmonary disease: GOLD opportunity for lung disorders

Background. The purpose of this study was to assess the agreement of asthma and chronic obstructive pulmonary disease (COPD) treatment prescribed by physicians and pulmonologists in comparison to asthma and COPD guidelines and the need of the implementation of COPD guidelines in primary health care physicians. Methods. Eighty-three asthma patients and 100 COPD patients were chosen and classified in relation to the agreement of their treatment prescribed by a health care physician and that mentioned by global initiative for chronic obstructive lung disease (GOLD) The COPD patients were classified according to their stage of the disease too. Results. Both pulmonologists and primary health care physicians manage asthma patients following asthma guidelines, while great proportion of COPD patients are undertreated by primary health care physicians. The proportion of undertreated COPD patients is decreased as the stage of disease is progressing. Conclusions. COPD patients mainly are undertreated by primary health care physicians when they are in the primary stages of the disease. The overtreatment of some patients consists of high doses of inhaled steroids prescribed by both pulmonologists, and mainly, primary health care physicians. Therefore, it can be concluded that there is the need of the implementation of COPD guideline by primary health care physicians and the need of COPD patients to, be, diagnosed in early stages by performing spirometry. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved

Reactive oxygen metabolites as an index of chronic obstructive pulmonary disease severity

Aim. The purpose of this study was to determine whether reactive oxygen metabolite species (ROMs) correlated with lung function in patients with chronic obstructive pulmonary disease (COPD) and to investigate whether ROMs could be used as an index of COPD severity. Methods. ROMs were evaluated in plasma by a colorimetric method (d-ROM-test) in 94 patients with COPD and in 31 healthy nonsmokers subjects. Spirometry, exhaled carbon monoxide and pulse oxymetry was performed in all patients. Results. Mean plasma ROMs were significantly increased (330.38 Carratelli units) in patients with COPD. There was a negative correlation of ROMs with forced expiratory volume in the first second (r=-0.275, P < 0.007), with forced vital capacity (r=-0.278, P < 0.007), with forced expiratory flow (r=-0.226, P < 0.029) and with oxygen saturation (r=-0.315, P < 0.010). In addition a positive correlation was found between the age of the patients and the oxidative stress (r=0.366, P < 0.000). Conclusions. These data indicate the presence of systemic oxidative stress in patients with COPD. The increased oxidative stress in COPD patients was concomitant with the impairment of lung function