Chinese Medical Sciences Journaldoi: 10.24920/J1001-9294.2017.034

• 论著 •    下一篇

阻塞性睡眠呼吸暂停与分泌性卷曲蛋白5(SFRP5)的相关性研究

张冬梅1, 黄蓉1,*(), 肖毅1, 龚凤英2, 钟旭1, 罗金梅1   

  1. 1中国医学科学院 北京协和医学院 北京协和医院 呼吸科, 北京,100730
    2中国医学科学院 北京协和医学院 北京协和医院 内分泌科,卫生部内分泌重点实验室, 北京 100730
  • 收稿日期:2017-03-07 出版日期:2017-12-30 发布日期:2017-12-30
  • 通讯作者: 黄蓉 E-mail:huangrong0212@163.com

Secreted Frizzled-Related Protein 5 (SFRP5) in Patients with Obstructive Sleep Apnea

Zhang Dongmei1, Huang Rong1,*(), Xiao Yi1, Gong Fengying2, Zhong Xu1, Luo Jinmei1   

  1. 1Department of Respiratory Medicine, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
    2Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
  • Received:2017-03-07 Published:2017-12-30 Online:2017-12-30
  • Contact: Huang Rong E-mail:huangrong0212@163.com

摘要: 目的

阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)与肥胖、胰岛素抵抗、炎症密切相关。分泌型卷曲蛋白5(secreted frizzled-related protein 5, SFRP5)是新近发现的一种脂肪因子,其参与肥胖患者胰岛素抵抗及炎症途径。本研究旨在探索SFRP5浓度与OSA患者睡眠参数及代谢指标的相关性。研究方法:采用前瞻性病例对照研究方法,序贯纳入健康对照和不合并糖尿病的OSA患者,并根据体重指数(BMI),分为体重正常的健康对照组、超重或肥胖的对照组和OSA组。所有受试者均行多导睡眠监测,并进行血液生化检测,包括血糖、血脂、超敏C反应蛋白和SFRP5。SFRP5检测采取酶联免疫法。对于完成行经鼻持续正压通气(nCPAP)的OSA患者,再次测定SFRP5浓度以作比较。

结果

共纳入68例研究对象,包括38例OSA患者,其中位呼吸暂停低通气指数(AHI)为58.70 (36.63, 71.15)次/小时;20例超重者对照;10例健康者对照。OSA组血浆SFRP5浓度与健康对照组及超重对照组差异无统计学意义。在OSA患者中,SFRP5与血清甘油三酯水平呈正相关(r =0.447,P = 0.005),与低密度脂蛋白(LDL)及高密度脂蛋白(HDL)呈负相关(r = -0.472, P = 0.003; r = -0.478, P = 0.002)。SFRP5 与血糖、AHI及夜间低氧指标无相关性。经cCPAP治疗一夜后,OSA患者SFRP5浓度较治疗前无显著变化(t =1.557,P = 0.148)。

结论

在不合并糖尿病的OSA患者中,血浆SFRP5浓度与血脂水平相关,而与血糖及睡眠参数无明显相关性,且与非OSA患者相比无显著性差异。

关键词: 分泌型卷曲蛋白5, 阻塞性睡眠呼吸暂停, 肥胖

Abstract: Objective

Obstructive sleep apnea (OSA) is closely related to obesity, insulin resistance and inflammation. Secreted frizzled-related protein 5 (SFRP5) is a recently discovered adipokine. It is involved in insulin resistance and inflammation in obesity. This study aimed at evaluating the association between SFRP5 and sleeping characteristics as well as biochemical parameters of OSA patients.

Methods

This was a prospective case control study. Nondiabetic OSA patients and controls were consecutively recruited and divided into three groups: OSA group, apnea-hypopnea Index (AHI)≥5/h; healthy controls with normal body mass index (BMI); obese controls without OSA, and BMI > 24.0 kg/m2. All participants underwent polysomnography (PSG). Plasma SFRP5 was examined using enzyme-linked immunosorbent assay (ELISA). Blood biochemical examinations, including fasting blood glucose (FBG), lipid profile, hypersensitive C-reactive protein (hsCRP), were performed early in the morning after PSG. Patients with severe OSA were treated with nasal continuous positive airway pressure (nCPAP), and plasma SFRP5 was repeatedly measured for comparison.

Results

Sixty-eight subjects were enrolled in the study, including 38 patients of OSA, whose medium AHI was 58.70 /h (36.63, 71.15), 20 obese controls, and 10 healthy controls. The plasma SFRP5 level of OSA patients was not significantly different from that of healthy controls or obese controls. In OSA patients, SFRP5 level correlated positively with triglyceride level (r=0.447, P=0.005) and negatively with LDL-cholesterol level and HDL- cholesterol level (r=-0.472 and P=0.003; r=-0.478 and P=0.002; respectively). SFRP5 level was not found correlating with FBG, AHI, or any of nocturnal hypoxia parameters. After overnight nCPAP treatment, plasma SFRP5 levels of OSA patients did not change significantly (t=1.557, P = 0.148) compared to that of pretreatment.

Conclusions

In nondiabetic OSA patients, plasma SFRP5 is associated with the lipid profile. However, no correlation was observed between SFRP5 and FBG or sleep parameters. The SFRP5 level of OSA patients did not differ from that of non-OSA individuals in our study.

Key words: secreted frizzled-related protein 5 (SFRP5), obstructive sleep apnea (OSA), obesity

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