Résumé :
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Background : Obesity hypoventilation syndrome (OHS) is associated with an increased cardiovascular mortality. Aim : To compare inflammatory status and endothelial function in OHS versus “uncomplicated obese” patients (UO), matched for BMI, age and sex. Methods : Blood gazes, CO2 ventilatory response, polysomnography and endothelial function, measured by reactive hyperemia peripheral arterial tonometry were assessed. Inflammatory (Leptin, RANTES,MCP1, IL6, IL8, TNF , Resistin) and anti-inflammatory (adiponectin, IL1-RA) cytokines were measured by multiplex beads immunoassays. Results : 14 OHS (BMI : 41±5.2 kgm-2, PaCO2 : 6.5±0.4 kPa, age : 57±10 years) and 39 UO patients (BMI : 40.9±5.1 kgm-2, PaCO2 : 5.3±0.4 kPa, 56±10 years) were included. PaCO2 was significantly higher in OHS (p<0.0001) whereas PaO2, vital capacity and CO2 chemoresponsiveness were lowered (p<0.02). Serum RANTES levels were significantly increased in OHS (55.9±55.3 vs 23.3±15.8 ng/ml p=0.003) and correlated with daytime PaCO2 (r=0.53 p=0.0001). Serum adiponectin was reduced in OHS (7.6±2.9 vs 13.7±7.8?g/ml p=0.004). Endothelial function was more impaired in OHS (p=0.006), negatively correlated with PaCO2 (r=-0.37 p=0.009) and positively with PaO2 (r=0.36 p=0.01). Conclusion : OHS is associated with a specific increase in the proatherosclerotic RANTES chemokine, a decrease in the antinflammatory adipokine adiponectin and impaired endothelial function. These three conditions are linked with an increased cardiovascular risk.
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