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

doi:10.24920/J1001-9294.2017.034

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

Zhang Dongmei, Huang Rong, Xiao Yi, Gong Fengying, Zhong Xu, Luo Jinmei. Secreted Frizzled-Related Protein 5 (SFRP5) in Patients with Obstructive Sleep Apnea[J/OL].Chinese Medical Sciences Journal, 2017-12-30.DOI:10.24920/J1001-9294.2017.034.[Epub ahead of print].

Figures/Tables 5

Table 1

Figure 1.

Figure 2.

Table 2

Figure 3.

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	HC	OW	OSA	P value
	n=10	n=20	n=38	HC vs. OW	HC vs. OSA	OW vs. OSA
age	30.80±10.25	36.10±13.70	40.87±9.01	0.623	0.032	0.340
BMI (kg/m²⁾	22.39±1.75	27.55±2.97	28.84±2.45	<0.001	<0.001	0.211
NC (cm)	37.80±2.20	41.55±2.14	43.11±2.02	<0.001	<0.001	0.026
WC (cm)	82.90±7.28	96.00±8.75	100.18±7.85	<0.001	<0.001	0.193
FBG (mmol/L)	5.07±0.37	5.12±0.73	5.48±0.92	1.000	0.457	0.318
TC (mmol/L)	4.47±1.10	4.80±0.77	5.07±0.87	1.000	0.186	0.821
TG (mmol/L)	1.40±0.79	1.97±2.15	3.11±3.51	1.000	0.482	0.306
HDL (mmol/L)	1.31±0.28	1.08±0.19	1.03±0.19	0.013	0.001	1.000
LDL (mmol/L)	2.65±0.87	3.04±0.74	3.15±0.77	0.611	0.228	1.000
hsCRP (mg/L)	2.09±3.46	1.19±1.14	2.19±1.94	0.791	1.000	0.242
ESS	5.50 (2.75, 10.00)	9.00 (5.25, 11.00)	10.50 (6.75, 13.00)	0.270	0.014	0.093
AHI	0.55 (0.08, 1.50)	2.00 (0.75, 2.78)	58.70 (36.63, 71.15)	0.052	<0.001	<0.001
Nadir SpO₂	91.80±3.19	89.85±3.44	72.79±11.95	1.000	<0.001	<0.001
Mean SpO₂	96.16±1.09	95.56±1.24	91.66±4.77	1.000	0.003	0.001
LST (%)	0.07±0.13	0.09±0.14	21.01±21.57	1.000	0.002	<0.001
SWS (%)	16.93±8.04	11.83±8.23	5.74±5.82	0.414	<0.001	<0.001
NREM (%)	82.00 ±5.34	76.31±8.51	79.45±10.48	0.364	1.000	0.687
REM (%)	13.34±4.03	15.47±8.06	13.77±5.84	1.000	1.000	1.000
SLT90 (%)	65.09±10.90	65.07±10.02	73.53±11.76	1.000	0.067	0.002

Parameters	SFRP5 (ng/mL)		Parameters	SFRP5 (ng/mL)
Parameters	r	P	Parameters	r	P
age	-0.237	0.153	AHI	0.237	0.152
BMI(kg/m²⁾	0.074	0.660	NREM (%)	0.197	0.282
NC (cm)	0.120	0.474	REM (%)	-0.056	0.737
WC (cm)	0.023	0.890	LST (%)	0.230	0.164
FBG (mmol/L)	-0.066	0.692	SWS (%)	0.160	0.338
TC (mmol/L)	0.303	0.064	SLT90 (%)	0.250	0.130
TG (mmol/L)	0.447	0.005	NadirSpO₂	-0.096	0.566
HDL (mmol/L)	-0.478	0.002	MeanSpO₂	-0.280	0.089
LDL (mmol/L)	-0.472	0.003	ESS	-0.213	0.198
hsCRP (mg/L)	0.271	0.100

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