脂肪型脂肪酸结合蛋白与阻塞性睡眠呼吸暂停综合征患者血脂异常的关系

Association between serum adipocyte fatty acid binding protein level and dyslipidemia in patients with obstructive sleep apnea syndrome

目的 探讨阻塞性睡眠呼吸暂停综合征（OSAS）患者血清中脂肪型脂肪酸结合蛋白（A-FABP）水平与血脂异常的关系.方法 收集2010年11月至2011年5月因打鼾在苏州大学附属第二医院呼吸睡眠中心行多导睡眠监测的患者80例,其中男63例,女17例；年龄22～77岁,平均（48±14）岁.按呼吸暂停低通气指数（AHI）将患者分为3组：单纯鼾症组（AHI＜5次/h）19例,轻中度OSAS组（5次/h≤AHI≤40次/h）22例,重度OSAS组（AHI＞ 40次/h）39例.测定空腹血中A-FABP及血总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平,分析A-FABP与血脂水平和睡眠呼吸参数的相关性.结果 重度OSAS组血清A-FABP水平为（20.4±4.6）μg/L,明显高于单纯鼾症组的（15.7±3.3）μg/L和轻中度OSAS组的（17.3±4.3）μg/L（P =0.001和P=0.026）.经校正年龄、体质指数之后,血清A-FABP与血TC、TG、LDL-C水平呈正相关（r=0.469、0.239、0.366,P=0.000、0.035、0.001）;血清A-FABP水平与睡眠呼吸暂停低通气指数和夜间动脉血氧饱和度（ SaO2）＜90％时间呈正相关（r=0.231,P=0.042和r=0.226,P=0.047）,与最低SaO2和平均SaO2呈负相关（r=-0.234,P=0.039和r=- 0.270,P=0.017）.结论 OSAS患者存在血脂异常及血清A-FABP水平的增高,血清A-FABP水平与OSAS患者的严重程度及低氧参数相关,提示血清A-FABP可能参与OSAS血脂异常的发生.

Objective To explore the association between serum adipocyte fatty acid binding protein （A-FABP） levels and dyslipidemia in patients with obstructive sleep apnea syndromes （OSAS）.Methods Eighty snoring patients were monitored by overnight polysomnography （PSG） in Second Affiliated Hospital of Soochow University from November 2010 to May 2011.There were 63 males and 17 females with a mean age of （48 ± 14） years （range： 22 -77 years）.Based on the results of apnea-hypopnea index （AHI）,they were divided into 3 groups： primary snoring group （AHI 〈5/h,n =19）,mild-moderate OSAS group （5/h ≤AHI ≤40/h,n =22） and severe OSAS group （ AHI 〉 40/h,n =39）.The levels of A-FABP,total cholesterol （ TC ）,triglyceride （ TG ）,low-density lipoprotein cholesterol （ LDL-C ） and high-density lipoprotein cholesterol （HDL-C） were measured and compared between the primary snoring group and OSAS patients of different severities.And the correlations between serum A-FABP and plasma lipid as well as PSG parameters were further evaluated by partial correlation analysis.Results Compared with the primary snoring group （ （ 15.7 ± 3.3 ） μg/L） and mild-moderate group （ （ 17.3 ± 4.3 ） μg/L）,there was a significant elevation of serum A-FABP level in the severe OSAS group （（20.4 ±4.6） μg/L） （P =0.001,P =0.026）.Additionally,after adjustment for body mass index and age,the serum A-FABP level showed significant positive correlations with TC,TG and LDL-C （ r =0.469,P =0.000 ; r =0.239,P =0.035 andr=0.366,P =0.001 ）.Serum A-FABP level was positively correlated with AHI and the time of oxygen saturation （SaO2） 〈90% （r =0.231,P =0.042 and r =0.226,P =0.047）.Nevertheless,the serum AFABP level showed significant negative correlations with the lowest SaO2 and the mean SaO2 （r =-0.234,P=0.039 and r =- 0.270,P =0.017 ）.Conclusion Dyslipidemia and elevated level of serum A-FABP are common in OSAS patients.