Circulating ICAM-1 and VCAM-1 levels in patients with obstructive sleep apnea syndrome

Respiration. 2007;74(5):525-32. doi: 10.1159/000097770. Epub 2006 Dec 4.


Background: Obstructive sleep apnea syndrome (OSAS)-induced hypoxic stress modulates circulating inflammatory mediators causing accelerated atherogenesis.

Objectives: We hypothesized that OSAS-induced hypoxia might result in cardiovascular disease due to increased expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) on the endothelial surface.

Methods: Thirty-nine subjects with moderate-to-severe OSAS and 34 non-apneic controls matched for age, gender, body mass index (BMI), smoking history, and cardiovascular disease were included in this prospective study. Overnight polysomnography was performed. Circulating ICAM-1 and VCAM-1 levels in the serum were measured by enzyme-linked immunosorbent assay.

Results: Circulating levels of both ICAM-1 (480.1 +/- 216.7 vs. 303.4 +/- 98.6 ng/ml, p < 0.0001) and VCAM-1 (1,156.6 +/- 79.8 vs. 878.8 +/- 71.1 ng/ml, p = 0.002) were significantly increased in the OSAS group compared to the control group. For an ICAM-1 cutoff level of 375 ng/ml, predictive sensitivity and specificity for OSAS were 69.2% (95% confidence interval, CI: 52.4-83.0%) and 82.4% (95% CI: 65.5-93.2%), respectively. For a VCAM-1 cutoff level of 859 ng/ml, predictive sensitivity and specificity for OSAS were 74.4% (95% CI: 57.9-86.9%) and 64.7% (95% CI: 46.5-80.2%), respectively. There was a significant positive correlation between circulating levels of ICAM-1 and ln of AHI (r = 0.276, p = 0.018). Multiple logistic regression analyses showed that OSAS was associated with high ICAM-1 and high VCAM-1 levels independent of age, gender, BMI, smoking status and cardiovascular disease.

Conclusion: We conclude that OSAS can independently increase circulating levels of adhesion molecules

MeSH terms

  • Adult
  • Female
  • Humans
  • Intercellular Adhesion Molecule-1 / blood*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • ROC Curve
  • Sleep Apnea, Obstructive / blood*
  • Vascular Cell Adhesion Molecule-1 / blood*


  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1