• Ambreen Qamar Dow University of Health Sciences
  • Zeba Haque Professor & HOD Dept. of Biochemistry, Dow International Medical College, DUHS, Karachi.
  • Sitwat Zehra Associate Professor, Dr.A.Q. Khan Institute of Biotechnology & Genetic Engineering (KIBGE) , University of Karachi
  • Mirza Saifullah Baig Assistant Professor Pulmonology, In-charge Pulmonology Unit III, Dow University of Health Sciences, Karachi.
Keywords: Sleep, Obstructive Sleep Apnoea, Interleukin-6, Inflammation


Background: Despite reported link between OSA and systemic inflammation, results are indecisive so far for different inflammatory markers to evaluate the casual relation with OSA and its co-morbidities. Objective of this study was to assess the relationship of inflammatory cytokine Interleukin-6 with obstructive sleep apnoea (OSA) and its severity among Pakistani population. Methodology: A total of 180 subjects (55 without apnoea, 33 mild, 34 moderate, and 58 with severe apnoea) were analysed in this cross-sectional study, between Dec 2018 and Jan 2020 in Dow University Hospital, Karachi. Apnoea was confirmed and subjects were grouped on the basis of Apnoea Hypopnea Index (AHI) by overnight Polysomnography. Plasma IL-6 was analysed using enzyme-linked immunosorbent assay (ELISA). One-way ANOVA was used for comparison. Potential effect of age and BMI was controlled using ANCOVA and effect size was reported as partial eta squared. Results: Mean IL-6 levels were associated with severity of apnoea with 4.72±1.50 pg/ml, 21.08±6.83 pg/ml, 25.41±7.97 pg/ml and 26.96±7.39 pg/ml in no OSA, mild, moderate and severe OSA respectively, with statistically significant difference between all groups except between moderate and severe OSA. After controlling the potential effect of age and BMI still yielded a significant positive association between severity of OSA and IL-6 levels (effect size (partial η2) of 59% (p<0.001)). Conclusion: Higher Interleukin-6 levels were observed in OSA and associated with its severity. It could provide a feasible method to improve timely diagnosis of OSA and can point toward presence of a more severe clinical phenotype.

Pak J Physiol 2021;17(2):15–9


Imani MM, Sadeghi M, Farokhzadeh F, Khazaie H, Brand S, Dursteler KM, et al. Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta-Analysis and Meta-Regression. Life. 2021;11(4).

Motamedi V, Kanefsky R, Matsangas P, Mithani S, Jeromin A, Brock MS, et al. Elevated tau and interleukin-6 concentrations in adults with obstructive sleep apnea. Sleep Med. 2018;43:71-6.

Gozal D, Serpero LD, Sans Capdevila O, Kheirandish-Gozal L. Systemic inflammation in non-obese children with obstructive sleep apnea. Sleep Med. 2008;9(3):254-9.

Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment. J Clin Sleep Med. 2019;15(2):301-34.

Tan HL, Kheirandish-Gozal L, Gozal D. The promise of translational and personalised approaches for paediatric obstructive sleep apnoea: an 'Omics' perspective. Thorax. 2014;69(5):474-80.

Qamar A, Haque Z, Baig MS, Owais M, Iffat W, Qamar A. Obstructive Sleep Apnoea: A Predictor of Abnormal Glucose Metabolism Pak J Physiol. 2018;14(3):5-8.

Qamar A, Ali SI, Ghuman F, Owais M, Ahmed R. Effeects of Obstructive Sleep Apnoea on lipid metabolism: A cross sectional study from a tertiary care hospital of Paksitan. Pak J Physiol. 2017;13(4):7-10.

Kheirandish-Gozal L, Gozal D. Obstructive Sleep Apnea and Inflammation: Proof of Concept Based on Two Illustrative Cytokines. Int J Mol Sci. 2019;20(3).

Huang YS, Guilleminault C, Hwang FM, Cheng C, Lin CH, Li HY, et al. Inflammatory cytokines in pediatric obstructive sleep apnea. Medicine. 2016;95(41):e4944.

Imani MM, Sadeghi M, Khazaie H, Emami M, Sadeghi Bahmani D, Brand S. Evaluation of Serum and Plasma Interleukin-6 Levels in Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression. Front Immunol. 2020;11:1343.

Rose-John S. Interleukin-6 signalling in health and disease. F1000Res. 2020;9.

Ting EY, Yang AC, Tsai SJ. Role of Interleukin-6 in Depressive Disorder. International journal of molecular sciences. 2020;21(6).

Rohleder N, Aringer M, Boentert M. Role of interleukin-6 in stress, sleep, and fatigue. Annals of the New York Academy of Sciences. 2012;1261:88-96.

Khan MA, Mujahid M. Recent Advances in Electrochemical and Optical Biosensors Designed for Detection of Interleukin 6. Sensors. 2020;20(3).

Gileles-Hillel A, Alonso-Alvarez ML, Kheirandish-Gozal L, Peris E, Cordero-Guevara JA, Teran-Santos J, et al. Inflammatory markers and obstructive sleep apnea in obese children: the NANOS study. Mediators Inflamm. 2014;2014:605280.

Qamar A, Qureshi M, Nazar S, Baig MS, Iffat W, Owais M. Physical activity and apnoea-hypopnea index in obstructive sleep apnoea. Pak J Physiol. 2019;15(3):67-70.

Qamar A, Baig MS, Nousheen S. Obstructive Sleep Apnea and Metabolic Syndrome; Causal Association or Co-Existence? . Med Forum. 2017;28(4):188-92.

Chu P, Ju YS, Hinze AM, Kim AHJ. Measures of Sleep in Rheumatologic Diseases: Sleep Quality Patient-Reported Outcomes in Rheumatologic Diseases. Arthritis Care Res. 2020;72 Suppl 10:410-30.

Van Eyck A, Van Hoorenbeeck K, De Winter BY, Van Gaal L, De Backer W, Verhulst SL. Sleep-disordered breathing, systemic adipokine secretion, and metabolic dysregulation in overweight and obese children and adolescents. Sleep medicine. 2017;30:52-6.

Tam CS, Wong M, McBain R, Bailey S, Waters KA. Inflammatory measures in children with obstructive sleep apnoea. Journal of paediatrics and child health. 2006;42(5):277-82.

Tietjens JR, Claman D, Kezirian EJ, De Marco T, Mirzayan A, Sadroonri B, et al. Obstructive Sleep Apnea in Cardiovascular Disease: A Review of the Literature and Proposed Multidisciplinary Clinical Management Strategy. J Am Heart Assoc. 2019;8(1):e010440.


Download data is not yet available.
How to Cite
Qamar A, Haque Z, Zehra S, Baig M. OBSTRUCTIVE SLEEP APNOEA AND ROLE OF INTERLEUKIN-6 AS A CIRCULATORY BIOMARKER: A CROSS-SECTION STUDY. PJP [Internet]. 30Jun.2021 [cited 29Sep.2022];17(2):15-9. Available from: http://pjp.pps.org.pk/index.php/PJP/article/view/1346

Most read articles by the same author(s)