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OSA severity was assessed via the apnea\u2013hypopnea index (AHI) and percent night time with SpO<jats:sub>2<\/jats:sub>\u2009&lt;\u200990% (T90).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The serum MMP-9 levels were significantly higher in the OSA patients (AHI\u2009\u2265\u20095\/h, 68.8\u2009\u00b1\u200944.9 ng\/mL) than the controls (49.0\u2009\u00b1\u200918.6 ng\/mL, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The MMP-2 levels showed no significant differences. When grouped into T90 quartiles, the MMP-9 levels were higher in the OSA patients in the highest quartile compared to those in the lowest quartile or the controls (90.6\u2009\u00b1\u200956.3 ng\/mL vs. 56.9\u2009\u00b1\u200931.9 ng\/mL, <jats:italic>p<\/jats:italic>\u2009=\u20090.022; 90.6\u2009\u00b1\u200956.3 ng\/mL vs. 49.0\u2009\u00b1\u200918.6 ng\/mL, <jats:italic>p<\/jats:italic>\u2009=\u20090.002, respectively). The MMP-9 levels correlated with T90 and the AHI (<jats:italic>r<\/jats:italic>\u2009=\u20090.36, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; <jats:italic>r<\/jats:italic>\u2009=\u20090.35, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, respectively). Multiple linear regression confirmed a significant association between MMP-9 and T90 after adjusting for body mass index, smoking status, and comorbidities (\u03b2\u2009=\u20090.53, <jats:italic>p<\/jats:italic>\u2009=\u20090.013). A similar association was observed for the AHI (\u03b2\u2009=\u20090.48, <jats:italic>p<\/jats:italic>\u2009=\u20090.019).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We concluded that serum MMP-9 levels are independently associated with OSA severity, particularly with T90 and the AHI, which suggests that MMP-9 could be a biomarker for OSA severity.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11325-025-03287-2","type":"journal-article","created":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T23:19:07Z","timestamp":1742685547000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Serum matrix metalloproteinase-9 as a potential biomarker for obstructive sleep apnea severity"],"prefix":"10.1007","volume":"29","author":[{"given":"So Yeon","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunyee","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Ho","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6537-8843","authenticated-orcid":false,"given":"Jaeyoung","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"issue":"15","key":"3287_CR1","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1056\/NEJMcp1816152","volume":"380","author":"SC Veasey","year":"2019","unstructured":"Veasey SC, Rosen IM (2019) Obstructive sleep apnea in adults. 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