Egger's test revealed a publication bias across the studies for serum and plasma IL-6 levels ( P = 0.00044 and P = 0.01445, respectively). Results of the meta-regression showed that greater age was associated with higher serum IL-6 levels.
The pooled analysis of serum and plasma IL-6 levels in children with OSAS compared with controls revealed that only the MD of plasma IL-6 levels was significant (MD = 0.84 pg/ml, P = 0.004). For adults, 37 studies reported significantly higher serum IL-6 levels and 20 reported significantly higher plasma IL-6 levels for those with OSAS than for healthy controls. Sixty-three studies (57 with adults six with children) were included in the present meta-analysis. The results of funnel plots and meta-regression were analyzed by the CMA 2.0 software. RevMan 5.3 software was used to calculate the crude mean difference (MD) and 95% confidence interval (CI). Four databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, were comprehensively searched to retrieve articles published up to December, 2019, with no further restrictions. The present meta-analysis and meta-regression aimed at comparing plasma and serum levels of IL-6 between individuals (children and adults) with OSAS and healthy controls. Interleukin-6 (IL-6) is one of the most significant inflammatory markers and an excellent proxy for the inflammatory/immune system.
Obstructive sleep apnea syndrome (OSAS) is considered a low-grade chronic inflammatory disease. 9School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.8Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.7Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, United States.6Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.5Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland.4Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.3Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.2Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.1Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah, Iran.Mohammad Moslem Imani 1, Masoud Sadeghi 2, Habibolah Khazaie 3, Mostafa Emami 4, Dena Sadeghi Bahmani 3,5,6,7 and Serge Brand 3,5,6,8,9 *
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