Can Obstructive Sleep Apnoea Lead to Increased Uric Acid Blood Levels?
Obstructive sleep apnoea is becoming a more common disorder. This medical condition, which is associated with sympathetic activation, metabolic deregulation, and neurocognitive changes, is marked by periods of apnoea and changes in blood oxygen concentration levels. Sleep apnoea is said to increase risks for coronary artery disease, heart failure, stroke, diabetes mellitus, obesity, dyslipidemia, and hypertension.
Lately there are reports that obstructive sleep apnoea can also lead to elevated blood uric acid levels. Elevated uric acid levels can lead to gout (deposition of uric acid crystals in the joints) and kidney failure.
A study was conducted to find out whether an association exists between OSAS and uric acid levels in the peripheral blood from a representative population of Sao Paulo (Brazil). A population-based survey adopting a probabilistic 3-stage cluster sample of Sao Paulo was used to represent the population according to gender, age, and socioeconomic class. A total of 1,042 volunteers underwent polysomnography recordings for obstructive sleep apnoea diagnosis, blood pressure assessment, and biochemical blood analysis, and answered questionnaires. In this study, uric acid levels were correlated with most important risk factors for obstructive sleep apnoea. Also, uric acid was increased in volunteers with obstructive sleep apnoea even after controlling for all confounders. Indeed, a strong association was found between uric acid levels and obstructive sleep apnoea, thus, uric acid levels may be involved in obstructive sleep apnoea severity and should be considered in sleep apnoea management in the future.
What could be the possible explanation for this? Inside the body, obstructive sleep apnoea is said to lead to decreased blood oxygen saturation and arousals during sleep. This further leads to increased production of reactive oxygen species (ROS) which can slow down our body’s metabolic processes. This can further impair the formation of adenosine triphosphate (ATP), an important energy-giving compound, leading to its degradation to adenosine diphosphate and adenosine monophosphate. This process further releases purine intermediates (adenosine, inosine, hypoxanthine and xanthine), ending with an overproduction of uric acid, the purine final catabolic product. This leads to increased uric acid levels in the blood.
The lesson? People with sleep apnoea should have their uric acid levels checked regularly, especially if they are at high risk for hyperuricemia or elevated uric acid levels in the blood.
Reference:
Hirotsu C, Tufik S, Guindalini C, Mazzotti DR, Bittencourt LR, Andersen ML. Association between uric Acid levels and obstructive sleep apnoea syndrome in a large epidemiological sample. PLoS One. 2013 Jun 24;8(6):e66891.
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