PRX5与T2DM伴OSAS患者严重程度及颈动脉粥样硬化的关系

Relationship between PRX5 and Severity and Carotid Atherosclerosis in Patients with T2DM with OSAS

目的分析2型糖尿病(T2DM)伴阻塞性睡眠呼吸暂停综合征(OSAS)患者血浆过氧化物酶5(PRX5)水平与其严重程度和并发颈动脉粥样硬化的关系。方法前瞻性选取2017年12月~2019年12月就诊的147例T2DM伴OSAS患者作为研究对象;采用酶联免疫吸附法检测血浆PRX5水平;比较不同严重程度T2DM伴OSAS患者血浆PRX5水平,并分析其与每小时睡眠发生呼吸暂停和低通气次数(AHI)的关系;比较并发组和对照组血浆PRX5水平,并分析其与T2DM伴OSAS并发颈动脉粥样硬化的关系;绘制受试者工作特征(ROC)曲线评价各模型诊断T2DM伴OSAS并发颈动脉粥样硬化的效能。结果T2DM伴OSAS患者血浆PRX5水平与AHI呈负相关(P<0.05)。并发组血浆PRX5水平低于对照组,差异有统计学意义(P<0.05)。Logistic多因素回归分析结果显示,空腹血糖(FPG)(OR=1.749,95%CI:1.177~2.600,P=0.006)、糖化血红蛋白(HbA1c)(OR=5.329,95%CI:1.951~14.557,P=0.001)、胰岛素抵抗指数(HOMA-IR)(OR=1.845,95%CI:1.144~2.976,P=0.012)、低密度脂蛋白胆固醇(LDL-C)(OR=4.532,95%CI:1.618~12.697,P=0.004)、AHI(OR=1.771,95%CI:1.369~3.901,P=0.007)和PRX5(OR=0.497,95%CI:0.335~0.736,P=0.000)均和T2DM伴OSAS患者颈动脉粥样硬化密切相关(P<0.05)。模型B诊断T2DM伴OSAS患者颈动脉粥样硬化的效能高于PRX5和模型A。结论T2DM伴OSAS患者血浆PRX5水平与AHI呈负相关。检测T2DM伴OSAS患者血浆PRX5水平有助于了解颈动脉粥样硬化情况。

Objective To analyze the relationship between plasma peroxiredoxin 5(PRX5)level and its severity and carotid atherosclerosis in patients with type 2 diabetes mellitus(T2DM)and obstructive sleep apnea syndrome(OSAS).Methods A prospective selection of 147 T2DM patients with OSAS from December 2017 to December 2019 was selected as the research object.Enzyme-linked immunosorbent assay was used to detect plasma PRX5 levels.The level of Prx5 in patients with different severity of T2DM and OSAS was compared,and the relationship between Prx5 and the frequency of apnea and hypoventilation(AHI)was analyzed.The level of Prx5 was compared between the concurrent group and the control group,and the relationship between Prx5 and carotid atherosclerosis in T2DM with OSAS was analyzed.The ROC curve was drawn to evaluate the efficacy of each model in diagnosing T2DM with OSAS complicated with carotid atherosclerosis.Results There was a negative correlation between Prx5 and AHI in T2DM patients with OSAS(P<0.05).The level of Prx5 in the concurrent group was lower than that in the control group(P<0.05).Logistic regression analysis showed that fasting plasma glucose(FPG)(OR=1.749,95%CI:1.177-2.600,P=0.006),glycated hemoglobin A1c(HbA1c)(OR=5.329,95%CI:1.951-14.557,P=0.001),homeostasis model assessment of insulin resistance(HOMA-IR)(OR=1.845,95%CI:1.144-2.976,P=0.012),low density lipoprotein cholesterol(LDL-C)(OR=4.532,95%CI:1.618-12.697,P=0.004),AHI(OR=1.771,95%CI:1.369-3.901,P=0.007)and Prx5(OR=0.497,95%CI:0.335-0.736,P=0.000)were closely related to carotid atherosclerosis in T2DM patients with OSAS(P<0.05).The efficacy of model B in diagnosing carotid atherosclerosis in T2DM patients with OSAS was higher than that of PRX5 and model A.Conclusion Plasma PRX5 levels in patients with T2DM and OSAS have a negative correlation with AHI.Detection of plasma PRX5 levels in patients with T2DM and OSAS is helpful to understand the status of carotid atherosclerosis.