| Overnight urinary uric acid: creatinine ratio for detection of sleep hypoxemia. Validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treatment with nasal continuous positive airway pressure. | |
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MedLine Citation:
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PMID: 8317794 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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During hypoxia ATP degradation to uric acid is increased in animal models and humans. To assess the reliability of an overnight increase in uric acid excretion as a marker of nocturnal hypoxemia, we selected 10 normal volunteers (7 males and 3 females), 29 COPD patients (26 males and 3 females), and 49 subjects with obstructive sleep apnea (OSA) (43 males and 6 females). The patients underwent standard polysomnography, which was repeated in 14 subjects with nasal continuous positive airway pressure (CPAP), and were subdivided into two groups: Group D included desaturating subjects who spent at least 1 h at SaO2 < 90% and 15 min below 85%, and Group ND were nondesaturating subjects. The overnight change in the uric acid:creatinine ratio (delta UA:Cr) was negative in normal subjects (-27.5 +/- 9.1 [mean +/- SD]) and ND groups: -19.7 +/- 14.3 in COPD, -16.1 +/- 13.0 in OSA. In both COPD and OSA Group D, the ratio was usually positive: delta UA:Cr was 17.9 +/- 31.4 in Group D COPD (p < 0.001 versus ND) and 10.1 +/- 30.7 in Group D OSA (p < 0.001 versus ND and versus normal subjects) despite 4 of 15 false negative results in COPD and 8 of 20 in OSA. CPAP effective treatment induced a marked reduction ((p = 0.0024) in delta UA:Cr, leading to a negative value. We conclude that delta UA:Cr seems to be a promising index of significant nocturnal tissue hypoxia, with good specificity but poor sensitivity (about 30% false negative), which might be useful for the long-term follow-up of outpatients on nasal CPAP with a positive ratio at baseline. |
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Authors:
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A Braghiroli; C Sacco; M Erbetta; V Ruga; C F Donner |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American review of respiratory disease Volume: 148 ISSN: 0003-0805 ISO Abbreviation: Am. Rev. Respir. Dis. Publication Date: 1993 Jul |
Date Detail:
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Created Date: 1993-07-28 Completed Date: 1993-07-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370523 Medline TA: Am Rev Respir Dis Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 173-8 Citation Subset: AIM; IM |
Affiliation:
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Division of Pulmonary Disease, IRCCS, Medical Rehabilitation Center, Veruno, Novara, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Anoxia / epidemiology, therapy, urine* Circadian Rhythm / physiology* Creatinine / urine* Female Humans Lung Diseases, Obstructive / epidemiology, therapy, urine* Male Middle Aged Polysomnography / statistics & numerical data Positive-Pressure Respiration* / statistics & numerical data Regression Analysis Sleep Apnea Syndromes / epidemiology, therapy, urine* Uric Acid / urine* |
| Chemical | |
Reg. No./Substance:
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60-27-5/Creatinine; 69-93-2/Uric Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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