Capacidade diagnóstica de marcadores salivares na síndrome da apneia obstrutiva do sono: revisão sistemática de literatura

Abstract

Objective – Evaluate the value of the salivary markers in the OSAS in comparison to the complete night polysomnography performed at the sleep laboratory. Material and methods – This review was carried out according to PRISMA guidelines and registered into PROSPERO under the registry number CRD42016037278. The data bases, PUBMED, EMBASE, MEDLINE, LILACS, BBO-ODO, COCHRANE and GOOGLE SCHOLAR made it possible to raise 232 reports. Articles until 21st March 2016 were researched irrestrictively to the publishing year and aimed at answering the PICO format question: “Is there any salivary biomarker that allows the early OSAS diagnosis?” QUADAS was the employed tool to assess the methodological quality of the studies and to calculate the risk of bias. Results – 15 studies were included for a detailed analysis, filling in the QUADAS form and for the extraction of salivary biomarkers diagnosis predictors for OSAS. Among the evaluated studies, 5 had 100% of the QUADAS forms filled in; 4 filled in 85,71%; and 6 studies 71,42%. Out of the 15 evaluated studies, 13 did not report sensitivity or specificity, making it impossible to fully assess the real diagnostic capacity of any alternative diagnostic test. Conclusion – The present systematic review identified possible salivary biomarkers for OSA, such as α-amylase and AHSG protein. However, the variability of the biomarkers evaluated the diversity among the samples studied, the small sample size, the difference in the definition of the classification for OSAS, as well as the absence of studies that validate these findings, make it difficult to delineate their use for clinical practice.