The Rise of IGFBP4 in People with Obstructive Sleep Apnea and Multilevel Sleep Surgery Recovers Its Basal Levels

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Abstract

IGFBP4 is the smallest member of the insulin-like growth factor binding protein family (IGFBP). It is a hepatic protein that plays a
role in modulating the activity and bioavailability of IGF-I. The expression of IGFBP4 was found to increase under conditions of
hypoxia. Obstructive sleep apnea (OSA) is a common disorder, characterized by cyclic episodes of intermittent hypoxia and
fragmented sleep. Our aim was to quantify levels of circulating IGFBP1, IGFBP2, IGFBP3, IGFBP4, and IGFBP7 in fasting
plasma samples of 69 Kuwaiti participants and explore its correlation with indices of OSA. The quantification was performed
using multiplexing assay. The study involved 28 controls and 41 patients with OSA. Levels of circulating IGFBP4 were
significantly higher in people with OSA (289:74 ± 23:30 ng/ml) compared to the control group (217:60 ± 21:74 ng/ml, p = 0:028
). The increase in IGFBP4 correlated significantly and positively with AHI (r = :574, p = :01) and AI (r = :794, p = :001) in
people with moderate and severe OSA. There was a significant decline in circulating IGFBP4 after 3 months of surgery
(225:89 ± 18:16 ng/ml, p = 0:012). This was accompanied by a prominent improvement in OSA (AHI 8:97 ± 2:37 events/h, p =
0:001). In this study, our data showed a significant increase in circulating IGFBP4 in people with OSA. We also report a
significant positive correlation between IGFBP4 and indices of OSA at baseline, which suggests IGFBP4 as a potential
diagnostic biomarker for OSA. There was a significant improvement in OSA after 3 months of surgical intervention, which
concurred with a significant decline in IGFBP4 levels. Altogether, the detected change suggests a potential link between
IGFBP4 and OSA or an OSA-related factor, whereby OSA might play a role in triggering the induction of IGFBP4 expression.Article ID 1219593
Original languageEnglish
Article number1219593
JournalDisease Markers
Volume2021
Publication statusPublished - 4 Oct 2021

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