Advanced Oxidation Protein Products in Obstructive Sleep Apnea Hypopnea Syndrome-A Systematic Review and Meta-Analysis.

Background: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a prevalent sleep-breathing disorder affecting both adults and children. Although previous studies have suggested a potential association between OSAHS and oxidative stress biomarkers, particularly advanced oxidation protein products (AOPP), their conclusive relationship remains unclear. This systematic review and meta-analysis aims to quantitatively synthesise existing evidence on the association between AOPP levels and OSAHS.

Methods: We comprehensively searched PubMed, Wiley Online Library, Cochrane Library, CBM, and CNKI databases up to October 2023. Two independent researchers screened studies investigating AOPP-OSAHS correlations, followed by data extraction and quality assessment. Statistical analyses were performed using Stata, with standardised mean differences (SMDs) calculated for pooled estimates.

Results: Nine studies comprising 608 patients and 770 controls were included. The meta-analysis demonstrated significantly elevated AOPP concentrations in OSAHS patients compared to controls (SMD = 1.66 , 95% CI = 1.02-2.29; I = 96%, p < 0.001). Meta-regression identified significant associations between effect sizes and publication year (β = 0.32, p = 0.016) as well as BMI (β = 0.25, p = 0.028), independent of geographic region, sample type, or analytical methods. Secondary analyses of oxidative stress markers revealed consistent elevations in SOD and MDA levels among OSAHS patients, whereas GSH showed no significant difference.

Conclusion: The meta-analysis confirmed a substantial increase in AOPP concentration in OSAHS patients compared to the control group, suggesting that the protein oxidation marker AOPP plays a role in the development of OSAHS and offering valuable insights for future clinical research.