阻塞性睡眠呼吸暂停低通气综合征患者CTRP12水平变化及相关因素研究

Study on the changes of CTRP12 level and related factors in patients with obstructive sleep apnea hypopnea syndrome

目的 :探讨肿瘤坏死因子相关蛋白12(C1q tumor necrosis factor related protein 12,CTRP12)在不同严重程度的阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者中的变化。方法:选取来自东南大学附属中大医院、江阴市人民医院、南京胸科医院睡眠呼吸监测中心进行多导睡眠图监测的受试者120例,分为OSAHS组及非OSAHS组。OSAHS组根据呼吸暂停低通气指数(apnea-hypopnea index,AHI)分为轻、中、重度组,各组再根据体重指数(body mass index,BMI)分为肥胖组、超重组、正常体重组,观察OSAHS患者体内CTRP12水平的变化及与AHI、最低血氧饱和度(lowest arterial O2saturation,LSa O2)、BMI、血脂、血糖等之间的关系,了解CTRP12在OSAHS中所起的作用。结果 :在BMI和OSAHS均匹配的各组患者中,睡前、醒后CTRP12的水平差异均无统计学意义;在BMI相匹配的各组中,重度OSAHS者睡前、醒后CTRP12的水平均明显低于非OSAHS及轻、中OSAHS者,正常体重轻、中度OSAHS者CTRP12水平明显低于非OSAHS者;在OSAHS相匹配的各组中,肥胖患者睡前、醒后CTRP12的水平均明显低于正常体重组;OSAHS患者血浆CTRP12水平与AHI、BMI、颈围、血氧饱和度低于90%的时间占睡眠总时间的百分比(percentage of time when oxygen saturation lower than 90%,SLT90%)、甘油三酯、空腹血糖、LSa O2、平均血氧饱和度(mean arterial O2saturation,MSa O2)相关,且随AHI、BMI、颈围、SLT90%、甘油三酯、空腹血糖的增加而降低,随LSa O2、MSa O2的增高而增高。结论:OSAHS患者体重、病情越重,CTRP12水平越低;OSAHS患者CTRP12水平与AHI、BMI、颈围、SLT90%、甘油三酯、空腹血糖呈负相关,与LSa O2和MSa O2呈正相关。

Objective：To investigate the changes of C1 q tumor necrosis factor related protein 12（CTRP12） in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）with different severity. Methods：A total of 120 cases were selected from Southeast University Affiliated Hospital,Jiangyin City People＇s Hospital,Chest Hospital Sleep Respiration Monitoring Center by polysomnography（PSG） monitoring,and divided into the OSAHS group and the non OSAHS group. The OSAHS group was divided into the light,medium and severe groups according to apnea hypopnea index（AHI）,and each group was divided into the obesity,overweight and normal weight groups according to body mass index（BMI）. CTRP12 level,AHI,the lowest oxygen saturation,BMI,blood lipid,blood sugar index in OSAHS patients were detected to understand the role of CTRP12 in OSAHS. Results： In BMI and OSAHS-matched patients of each group,the levels of CTRP12 before sleep and after wake up had no statistical difference;in BMI-matched groups,CTRP12 levels before sleep and after wake up of severe OSAHS patients were significantly lower than those of non OSAHS,light OSAHS,and medium OSAHS patients. CTRP12 levels in light and medium OSAHS patients with normal weight were significantly lower than those in non OSAHS patients;in OSAHS-matched groups,CTRP12 levels of obese patients before sleep and after wake up were significantly lower than those of patients with normal weight;plasma CTRP12 level of OSAHS patients was related to AHI,BMI,neck circumference,percentage of time when oxygen saturation lower than 90%（SLT90%）,triglyceride,fasting blood glucose,lowest arterial O2saturation（LSa O2）,and mean arterial O2saturation（MSa O2）. The CTRP12 level was decreased when AHI,BMI,neck circumference,SLT90%,triglyceride,fasting blood glucose increased,and was increased when LSa O2 and MSa O2 increased.Conclusion：The level of CTRP12 was decreased when OSAHS patients with more severe disease and heavier body weight;OSAHS patients plasma CTRP12 level was negatively correlated with AHI,BMI,neck circumference,SLT90%,triglyceride,fasting blood glucose and positively related with LSa O2 and MSa O2.