OSAHS患者食欲素-A、瘦素水平测定及其临床意义被引量：1

Plasma orexin-A and serum leptin levels in patients with obstructive sleep apnea/hypopnea syndrome

下载PDF

导出

摘要目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者食欲素-A、瘦素的变化及其临床意义。方法选择年龄及体重指数(BMI)差异无统计学意义OSAHS患者(55例)与正常对照者(28例)用多导睡眠图(PSG)仪进行7h睡眠监测,用放射免疫法测定两者血浆食欲素-A和血清瘦素水平。结果OSAHS患者食欲素-A(1.95±0.67)pg/ml和瘦素(19.22±6.99)ng/ml水平均高于正常对照者(1.61±0.45)pg/ml和(9.80±4.0)ng/m(lt=2.36,6.59P<0.05或<0.01);非肥胖OSAHS患者食欲素-A(2.01±0.67)pg/ml、瘦素(15.91±5.76ng/ml)也较非肥胖对照者高(1.60±0.40)pg/ml、(7.87±1.94)ng/ml(t=2.27,5.62P<0.05或<0.01)。食欲素-A与年龄、呼吸暂停低通气指数(AHI)、氧减指数(ODI4)及微觉醒指数(MAI)呈正相关(r=0.3890.4790.5990.277P<0.01或<0.05),与BMI无相关性(r=0.40P>0.05)。瘦素与AHI、ODL4、BMI呈正相关(r=0.5490.4350.407P<0.01)。结论OSAHS患者血浆食欲素-A和血清瘦素水平升高,其原因可能与患者夜间反复发作性低氧有关,食欲素-A还与睡眠-觉醒的调节机制有关。 Objective To To explore the changes and implications of plasma orexin-A and serum leptin levels in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). Methods Polysomnography (PSG) was performed in 36 obese OSAHS patients,19 nonobesity OSAHS patients and 10 obese subjects,18 normal healthy adults. Plasma orexin-A and serum leptin levels were measured by radioimmunoassay. Results Plasma orexin-A and serum leptin levels in patients with OSAHS were significantly higher than those in control group (1.95±0.67pg/ml vs 1.61±0.45pg/ml and 19.22±6.99ng/ml vs 9.80±4.0 ng/ml, P<0.01). Plasma orexin-A and serum leptin levels in nonobesity patients with OSAHS were significantly higher than those in nonobesity control group(2.01±0.67pg/ml vs 1.60±0.40pg/ml and 15.91±5.76ng/ml vs 7.87±1.94ng/ml, P<0.05). Serum leptin levels in obesity patients with OSAHS was significantly higher than those in obesity controls group and nonobesity patients with OSAHS (20.97±7.01ng/ml vs 13.27±4.48ng/ml and 15.91±5.76ng/ml, P<0.01). Orexin-A was correlated positively with Age, AHI,ODI4 and Micro arousal index (r=0.389,0.479,0.599,0.277,P<0.01or 0.05). Leptin was correlated positively with BMI, AHI,ODI4(r=0.549,0.435,0.407,P<0.01). Conclusions Plasma orexin-A and serum leptin levels were higher in OSAHS patients than those in control groups. Besides obesity, OSAHS may also affect the orexin-A and leptin systems, resulting in the increases of plasma orexin-A and serum leptin levels.

作者钦光跃黄勍栋吴健王国付杜坚宗周欢琴于彭

机构地区浙江医院呼吸内科

出处《浙江医学》 CAS 2007年第2期114-116,共3页 Zhejiang Medical Journal

基金浙江省自然科学基金资助项目(X204002)

关键词阻塞性睡眠呼吸暂停低通气综合征食欲素-A瘦素微觉醒 Obstructive sleep apnea hypopnea syndrome Orexin-A Leptin Microarousal

分类号 R766 [医药卫生—耳鼻咽喉科]

引文网络
相关文献

参考文献14

1[1]Meister B.Control of food intake via leptin receptors in hypothalamus[J].Vitam Horm,2000,59:265-304.
2中华医学会呼吸病学分会睡眠呼吸疾病学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(草案)[J].中华结核和呼吸杂志,2002,25(4):195-198. 被引量：1845
3[4]Young T,Palta M,Dempsey J,et al.The occurrence of sleep-disordered breething among middle-aged adults[J].N Engl J Med,1 993,328:1230-1235.
4[5]Vontzas AN,Tan TL,Bixler Eo,et al.Sleep apnea and sleep disruptionin obese patients[J].Arch Interm Med,1994,154:1705-1711.
5[6]Sakurai T.Orexins and orexin receptors:implication in feeding behaviour[J].Regul Pept,1999,85:25-30.
6熊雯,于常声,周建华.Orexin(Hypocretin)研究新进展[J].医学综述,2002,8(10):565-567. 被引量：6
7[8]Kastin AJ,Akerstrom V.Orexin A but not orexin B rapidly enters brain from blood by simple diffusion[J].J Pharmacol Exp Ther,1999,289:219-223.
8[9]Adam JA,Menheere PP,Van Dielen FM,et al.Decreased plasma orexin-A levels in obese individuals[J].Int J Obes Relat Metab Disord,2002,26:274-276.
9[10]Nishijima T,Sakurai S,Arihara Z,et al.Plasma orexin-Alike immunoreactivity in patients wish sleep apnea hypinea syndrome[J].Peptides,2003,24:407-411.
10[11]Igarashi N,Tatsumi K,Nakamura A,et al.Plasma orexin-A levels in obstructive sleep apnea-hypopnea syndrome[J].Chest,2003,124:1381-1385.

二级参考文献25

1林江涛翁心植.慢性阻塞性肺疾病与肺源性心脏病[M].北京:北京出版社,1999.366-381.
2中华医学会呼吸病学分会.慢性阻塞性肺疾病（COPD）诊治规范[J].中华结核和呼吸杂志,1997,20:99-106.
3[1]de Lecea L,Kilduff TS,Peyron C,et al.The hypocretins:hypothalamus-specific peptides with neuroexcitatory activity[J].Proc Natl Acad Sci USA,1998,95(1):322-327.
4[2]Sakurai T,Amemiya A,Ishii M,et al.Orexins and orexin receptors:a family of hypothalamic neuropeptides and G protein-coupled receptor that regulate feeding behavior[J].Cell,1998,92(4):573-585.
5[3]Tahei S,Bloom S.Orexins/hypocritins:waking up the scientific world[J].Clin Endocrinol,2001,54(4):421-429.
6[4]Johren O,Neidert SJ,Kummer M,et al.Prepro-orexin and orexin receptor mRNAs are differentially expressed in peripheral tissues of male and female rats[J].Endocrinology,2001,142(8):3324-3331.
7[5]Mullett MA,Billington CJ,Levine AS,et al.Hypocretin 1 in the lateral hypothalamus activates key feeding-regulatory brain sites[J].Neuroreport,2000,11(1):103-108.
8[6]Land PE,Shariatmadan R,Uustere A,et al.The orexin-1 receptor activate a novel Ca2+ influx pathway necessary for coupling to phospholipase C[J].J Biochem,2000,275(7):30806-30812.
9[7]Shirasaka T,Satoshi M,Takato K,et al.Orexin depolarizes rat hypothalamic paraventricular nucleus neurons[J].Am J Physiol Regul Integr Comp Physiol,2001,281(7):Rl114-1118.
10[8]Smart D,Sabido-David C,Brough SJ,et al.SB-334867-A:the first selective orexin-I receptor antagonist[J].Brit J Pharmacol,2001,132(6):1179-1182.