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Serum Levels of Adipocyte Fatty Acid–Binding Protein Are Independently Associated With Left Ventricular Mass and Myocardial Performance Index in Obstructive Sleep Apnea Syndrome
  1. Mustafa Mücahit Balci, MD*,
  2. Uğur Arslan, MD,
  3. Hikmet Firat, MD,
  4. İbrahim Kocaoğlu, MD*,
  5. Mustafa Gökhan Vural, MD§,
  6. Kevser Gülcihan Balci, MD§,
  7. Orhan Maden, MD*,
  8. Oğuz Alp Gürbüz, MD,
  9. Sadık Ardiç, MD,
  10. Ekrem Yeter, MD§
  1. From the *Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara; †Department of Cardiology, Samsun Education and Research Hospital, Samsun; Departments of ‡Pulmonary Diseases, §Cardiology, and ∥Microbiology, Diskapi Education and Research Hospital, Ankara, Turkey.
  1. Received March 2, 2012, and in revised form June 28, 2012.
  2. Accepted for publication June 28, 2012.
  3. Reprints: Uğur Arslan, MD, Güvenlik Caddesi No: 38/4, A. Ayranci, Ankara, Turkey. E-mail: ugurarslan5{at}


Objective To investigate the cross-sectional association between serum adipocyte fatty acid–binding protein (A-FABP) level and diagnosis or severity of obstructive sleep apnea syndrome (OSAS) and some echocardiographic indices related with cardiac dysfunction.

Methods In this study, plasma A-FABP and high-sensitivity C-reactive protein concentrations were measured, and echocardiography was performed in subjects without any cardiac or pulmonary disease who were referred for evaluation of OSAS. According to the apnea-hypopnea index (AHI), subjects were classified into 3 groups: control group (AHI <5; n = 33), mild to moderate OSAS (30 > AHI ≥ 5; n = 30), and severe OSAS (AHI ≥ 30; n = 31).

Results Levels of A-FABP were significantly different between the groups (P < 0.001). After post hoc analyses, all 3 groups were also significantly different from each other. The levels of A-FABP were significantly higher in the patients with severe OSAS (36.4 ± 13.0 ng/mL) than in the control subjects (9.3 ± 4.6 ng/mL; P < 0.0001) or in patients with mild-moderate OSAS (24.5 ± 10.5 ng/mL; P < 0.001). Patients with myocardial performance index (MPI) greater than 0.47 had higher serum A-FABP levels than those with MPI of less than 0.47 (31.8 ± 13.2 ng/mL vs 10.9 ± 6.3 ng/mL; P = 0.001). Multivariable regression analyses revealed that increased serum A-FABP concentrations were independently associated with increased left ventricular mass index (β = 0.195; P = 0.033) and increased MPI (β = 0.165; P = 0.015).

Conclusions Increased A-FABP levels were found in the patients with OSAS, which were correlated significantly with left ventricular mass index and MPI. Further prospective studies are needed to clarify whether increased serum A-FABP level is a marker or a potential mechanism for left ventricular involvement in patients with OSAS.

Key Words
  • adipocyte fatty acid binding protein
  • obstructive sleep apnea
  • echocardiography

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