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Published in: Sleep and Breathing 1/2012

01-03-2012 | Original Article

The relation between Lp-PLA2 levels with periodic limb movements

Authors: Taha Tahir Bekci, Mehmet Kayrak, Aysel Kiyici, Hatem Ari, Turgut Teke, Emin Maden, Hakan Akilli

Published in: Sleep and Breathing | Issue 1/2012

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Abstract

Objective

Lipoprotein-associated phospholipase A2 (Lp-PLA2), a novel marker of vulnerable plaque to prone rupture, is a predictor of both cardiovascular event and cerebrovascular event, and highly sensitive-C-reactive protein (hs-CRP) is an acute-phase response protein implicated in a broad range of cardiovascular diseases. We aimed to examine the association between periodic limb movements in sleep (PLMs) with circulating Lp-PLA2 and hs-CRP levels in patients with PLMs.

Methods

Seventy patients with newly diagnosed PLM with polysomnography were enrolled this study. Patients were divided into two groups according to PLM index (normal PLM index, <15; elevated PLM index, ≥15). Lp-PLA2 and hs-CRP concentrations were measured in serum samples by turbidimetric and nephelometric methods, respectively. The concentrations of these parameters were compared between two groups and correlation analysis was performed between PLMs and Lp-PLA2 and hs-CRP levels.

Results

Lp-PLA2 levels and hs-CRP were significantly increased in elevated PLM index group compared with the control group (206.8 ± 78.1 vs 157.8 ± 56.7, p = 0.003, and 4.2 ± 3.5 vs 2.4 ± 2.1, p = 0.02, respectively). PLM index was positively correlated with Lp-PLA2 levels (r = 0.40, p = 0.001) and hs-CRP (r = 0.24, p = 0.05). In the linear regression model, Lp-PLA2 was an independent predictor of PLM index (R 2 = 0.36, p = 0.005).

Conclusion

This study demonstrated an independent linear relation between PLM index and Lp-PLA2. In addition, it was seen increased Lp-PLA2 and hs-CRP levels in patients with elevated PLM index. Based on these results, we can suggest that risk of vascular events may be increased in patients with PLMs and with increased PLM index.
Literature
1.
go back to reference Ali NJ, Davies RJ, Fleetham JA, Stradling JR (1991) Periodic movements of the legs during sleep associated with rises in systemic blood pressure. Sleep 14:163–165PubMed Ali NJ, Davies RJ, Fleetham JA, Stradling JR (1991) Periodic movements of the legs during sleep associated with rises in systemic blood pressure. Sleep 14:163–165PubMed
2.
go back to reference Sforza E, Nicolas A, Lavigne G, Gosselin A, Petit D, Montplaisir J (1999) EEG and cardiac activation during periodic leg movements in sleep: support for a hierarchy of arousal responses. Neurology 52:786–791PubMed Sforza E, Nicolas A, Lavigne G, Gosselin A, Petit D, Montplaisir J (1999) EEG and cardiac activation during periodic leg movements in sleep: support for a hierarchy of arousal responses. Neurology 52:786–791PubMed
3.
go back to reference Sforza E, Juony C, Ibanez V (2002) Time-dependent variation in cerebral and autonomic activity during periodic leg movements in sleep: implications for arousal mechanisms. Clin Neurophysiol 113:883–891PubMedCrossRef Sforza E, Juony C, Ibanez V (2002) Time-dependent variation in cerebral and autonomic activity during periodic leg movements in sleep: implications for arousal mechanisms. Clin Neurophysiol 113:883–891PubMedCrossRef
4.
go back to reference Sforza E, Pichot V, Barthelemy JC, Haba-Rubio J, Roche F (2005) Cardiovascular variability during periodic leg movements: a spectral analysis approach. Clin Neurophysiol 116:1096–1104PubMedCrossRef Sforza E, Pichot V, Barthelemy JC, Haba-Rubio J, Roche F (2005) Cardiovascular variability during periodic leg movements: a spectral analysis approach. Clin Neurophysiol 116:1096–1104PubMedCrossRef
5.
go back to reference Pennestri MH, Montplaisir J, Colombo R, Lavigne G, Lanfranchi PA (2007) Nocturnal blood pressure changes in patients with restless legs syndrome. Neurology 68:1213–1218PubMedCrossRef Pennestri MH, Montplaisir J, Colombo R, Lavigne G, Lanfranchi PA (2007) Nocturnal blood pressure changes in patients with restless legs syndrome. Neurology 68:1213–1218PubMedCrossRef
6.
go back to reference Siddiqui F, Strus J, Ming X, Lee IA, Chokroverty S, Walters AS (2007) Rise of blood pressure with periodic limb movements in sleep and wakefulness. Clin Neurophysiol 118:1923–1930PubMedCrossRef Siddiqui F, Strus J, Ming X, Lee IA, Chokroverty S, Walters AS (2007) Rise of blood pressure with periodic limb movements in sleep and wakefulness. Clin Neurophysiol 118:1923–1930PubMedCrossRef
7.
go back to reference Hanly P, Zuberi N (1992) Periodic leg movements during sleep before and after heart transplantation. Sleep 15:489–492PubMed Hanly P, Zuberi N (1992) Periodic leg movements during sleep before and after heart transplantation. Sleep 15:489–492PubMed
8.
go back to reference Hanly PJ, Zuberi-Khokhar N (1996) Periodic limb movements during sleep in patients with congestive heart failure. Chest 109:1497–1502PubMedCrossRef Hanly PJ, Zuberi-Khokhar N (1996) Periodic limb movements during sleep in patients with congestive heart failure. Chest 109:1497–1502PubMedCrossRef
9.
go back to reference Packard CJ, O’Reilly DS, Caslake MJ, McMahon AD, Ford I, Cooney J, Macphee CH, Suckling KE, Krishna M, Wilkinson FE, Rumley A, Lowe GD (2000) Lipoprotein-associated phospholipase A2, as an independent predictor of coronary heart disease. West of Scotland coronary prevention study group. N Engl J Med 343:1148–1155PubMedCrossRef Packard CJ, O’Reilly DS, Caslake MJ, McMahon AD, Ford I, Cooney J, Macphee CH, Suckling KE, Krishna M, Wilkinson FE, Rumley A, Lowe GD (2000) Lipoprotein-associated phospholipase A2, as an independent predictor of coronary heart disease. West of Scotland coronary prevention study group. N Engl J Med 343:1148–1155PubMedCrossRef
10.
go back to reference Ballantyne CM, Hoogeveen RC, Bang H, Coresh J, Folsom AR, Heiss G, Sharrett AR (2004) Lipoprotein-associated phospholipase A2, high sensitive c-reactive protein and risk for incident coronary heart disease in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study. Circulation 109:837–842PubMedCrossRef Ballantyne CM, Hoogeveen RC, Bang H, Coresh J, Folsom AR, Heiss G, Sharrett AR (2004) Lipoprotein-associated phospholipase A2, high sensitive c-reactive protein and risk for incident coronary heart disease in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study. Circulation 109:837–842PubMedCrossRef
11.
go back to reference Koenig W, Khuseyinova N, Löwel H, Trischler G, Meisinger C (2004) Lipoprotein-associated phospholipase A2 adds to risk prediction of incident coronary events by C-reactive protein in apparently healthy middle-aged men from the general population. Results from the 14-year follow-up of a large cohort from southern Germany. Circulation 110:1903–1908, OeiPubMedCrossRef Koenig W, Khuseyinova N, Löwel H, Trischler G, Meisinger C (2004) Lipoprotein-associated phospholipase A2 adds to risk prediction of incident coronary events by C-reactive protein in apparently healthy middle-aged men from the general population. Results from the 14-year follow-up of a large cohort from southern Germany. Circulation 110:1903–1908, OeiPubMedCrossRef
12.
go back to reference Elkind MS, Tai W, Coates K, Paik MC, Sacco RL (2009) Lipoprotein-associated phospholipase A2 activity and risk of recurrent stroke. Cerebrovasc Dis 27(1):42–50PubMedCrossRef Elkind MS, Tai W, Coates K, Paik MC, Sacco RL (2009) Lipoprotein-associated phospholipase A2 activity and risk of recurrent stroke. Cerebrovasc Dis 27(1):42–50PubMedCrossRef
13.
go back to reference Rechtschaffen A, Kales A (1968) A manual of standardized terminolgy, techniques and scoring system for sleep stages in human subjects. The National Institutes of Health, Washington DC Rechtschaffen A, Kales A (1968) A manual of standardized terminolgy, techniques and scoring system for sleep stages in human subjects. The National Institutes of Health, Washington DC
14.
go back to reference Iber C, Ancoli-Israel S, Chesson AL, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. American Academy of Sleep Medicine, Westchester, Ill Iber C, Ancoli-Israel S, Chesson AL, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications. American Academy of Sleep Medicine, Westchester, Ill
15.
go back to reference Roepke SK, Ancoli-Israel S (2010) Sleep disorders in the elderly. Indian J Med Res 131:302–310PubMed Roepke SK, Ancoli-Israel S (2010) Sleep disorders in the elderly. Indian J Med Res 131:302–310PubMed
16.
go back to reference Natarajan R (2010) Review of periodic limb movement and restless leg syndrome. J Postgrad Med 56(2):157–162PubMedCrossRef Natarajan R (2010) Review of periodic limb movement and restless leg syndrome. J Postgrad Med 56(2):157–162PubMedCrossRef
17.
go back to reference Guilleminault C, Crowe C, Quera-Salva MA, Miles L, Partinen M (1988) Periodic leg movements, sleep fragmentation and central sleep apnea in two cases:reduction with clonazepam. Eur Respir J 1:762–765PubMed Guilleminault C, Crowe C, Quera-Salva MA, Miles L, Partinen M (1988) Periodic leg movements, sleep fragmentation and central sleep apnea in two cases:reduction with clonazepam. Eur Respir J 1:762–765PubMed
18.
go back to reference Somers VK, Dyken ME, Mark AL, Abboud FM (1993) Sympathetic nevre activity during sleep in normal subjects. N Eng J Med 328:303–307CrossRef Somers VK, Dyken ME, Mark AL, Abboud FM (1993) Sympathetic nevre activity during sleep in normal subjects. N Eng J Med 328:303–307CrossRef
19.
go back to reference Davies RJ, Belt PJ, Roberts SJ, Ali NJ, Stradling JR (1993) Arterial blood pressure responses to graded transient arousal from sleep in normal humans. J Appl Physiol 74:1123–1130PubMed Davies RJ, Belt PJ, Roberts SJ, Ali NJ, Stradling JR (1993) Arterial blood pressure responses to graded transient arousal from sleep in normal humans. J Appl Physiol 74:1123–1130PubMed
20.
go back to reference Ekstedt M, Akerstedt T, Soderstrom M (2004) Microarousals during sleep are associated with increased levels of lipids, cortisol, and blood pressure. Psychosom Med 66:925–931PubMedCrossRef Ekstedt M, Akerstedt T, Soderstrom M (2004) Microarousals during sleep are associated with increased levels of lipids, cortisol, and blood pressure. Psychosom Med 66:925–931PubMedCrossRef
21.
go back to reference Walters AS, Rye DB (2009) Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep 32(5):589–597PubMed Walters AS, Rye DB (2009) Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep 32(5):589–597PubMed
22.
go back to reference Insull W Jr (2009) The pathology of atherosclerotic plaque development and plaque responses to medical treatment. Am J Med 122:S3–S14PubMedCrossRef Insull W Jr (2009) The pathology of atherosclerotic plaque development and plaque responses to medical treatment. Am J Med 122:S3–S14PubMedCrossRef
23.
go back to reference Kher N, Marsh JD (2004) Pathobiology of atherosclerosis: a review. Semin Thromb Hemost 30:665–672PubMedCrossRef Kher N, Marsh JD (2004) Pathobiology of atherosclerosis: a review. Semin Thromb Hemost 30:665–672PubMedCrossRef
24.
go back to reference Winkelman JW, Shahar E, Sharief I, Gottlieb DJ (2008) Associations of restless legs syndrome and cardiovascular disease in the sleep heart health study. Neurology 70:35–42PubMedCrossRef Winkelman JW, Shahar E, Sharief I, Gottlieb DJ (2008) Associations of restless legs syndrome and cardiovascular disease in the sleep heart health study. Neurology 70:35–42PubMedCrossRef
25.
go back to reference Schwedler SB, Filep JG, Galle J, Wanner C, Potempa LA (2006) C-reactive protein: a family of proteins to regulate cardiovascular function. Am J Kidney Dis 47(2):212–222PubMedCrossRef Schwedler SB, Filep JG, Galle J, Wanner C, Potempa LA (2006) C-reactive protein: a family of proteins to regulate cardiovascular function. Am J Kidney Dis 47(2):212–222PubMedCrossRef
26.
go back to reference Teoh H, Quan A, Lovren F, Wang G, Tirgari S, Szmitko PE, Szalai AJ, Ward ME, Verma S (2008) Impaired endothelial function in C-reactive protein overexpressing mice. Atherosclerosis 201(2):318–325PubMedCrossRef Teoh H, Quan A, Lovren F, Wang G, Tirgari S, Szmitko PE, Szalai AJ, Ward ME, Verma S (2008) Impaired endothelial function in C-reactive protein overexpressing mice. Atherosclerosis 201(2):318–325PubMedCrossRef
27.
go back to reference Chung S, Yoon IY, Shin YK, Lee CH, Kim JW, Ahn HJ (2009) Endothelial dysfunction and inflammatory reactions of elderly and middle-aged men with obstructive sleep apnea syndrome. Sleep Breath 13(1):11–17PubMedCrossRef Chung S, Yoon IY, Shin YK, Lee CH, Kim JW, Ahn HJ (2009) Endothelial dysfunction and inflammatory reactions of elderly and middle-aged men with obstructive sleep apnea syndrome. Sleep Breath 13(1):11–17PubMedCrossRef
28.
go back to reference Ye J, Liu H, Li Y, Liu X, Zhu JM (2007) Increased serum levels of C-reactive protein and matrix metalloproteinase-9 in obstructive sleep apnea syndrome. Chin Med J Engl 120(17):1482–1486PubMed Ye J, Liu H, Li Y, Liu X, Zhu JM (2007) Increased serum levels of C-reactive protein and matrix metalloproteinase-9 in obstructive sleep apnea syndrome. Chin Med J Engl 120(17):1482–1486PubMed
29.
go back to reference Punjabi NM, Beamer BA (2007) C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep 30(1):29–34PubMed Punjabi NM, Beamer BA (2007) C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep 30(1):29–34PubMed
30.
go back to reference Kapsimalis F, Varouchakis G, Manousaki A, Daskas S, Nikita D, Kryger M, Gourgoulianis K (2008) Association of sleep apnea severity and obesity with insulin resistance, C-reactive protein, and leptin levels in male patients with obstructive sleep apnea. Lung 186(4):209–217PubMedCrossRef Kapsimalis F, Varouchakis G, Manousaki A, Daskas S, Nikita D, Kryger M, Gourgoulianis K (2008) Association of sleep apnea severity and obesity with insulin resistance, C-reactive protein, and leptin levels in male patients with obstructive sleep apnea. Lung 186(4):209–217PubMedCrossRef
Metadata
Title
The relation between Lp-PLA2 levels with periodic limb movements
Authors
Taha Tahir Bekci
Mehmet Kayrak
Aysel Kiyici
Hatem Ari
Turgut Teke
Emin Maden
Hakan Akilli
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Sleep and Breathing / Issue 1/2012
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-010-0464-y

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