骨保护素/核因子кB受体活化因子配体、小泛素样修饰蛋白特异性蛋白酶1、脂蛋白相关磷脂酶A2与阻塞性睡眠呼吸暂停低通气综合征病情程度的关系及其预测心血管事件价值分析

Relationship between OPG/RANKL,SENP-1,Lp-PLA2 and the severity of obstructive OSAHS and its predictive value for CVE were analyzed

目的分析骨保护素(OPG)/核因子кB受体活化因子配体(RANKL)、小泛素样修饰蛋白特异性蛋白酶1(SENP-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)病情程度的关系及各指标预测心血管事件(CVE)价值。方法纳入2021年9月至2022年9月于河北省胸科医院接受治疗的120例OSAHS患者,根据病情分为轻度组、中度组、重度组,比较三组患者的基线资料,采用多元logistics回归分析OPG/RANKL、SENP-1、Lp-PLA2与阻塞性OSAHS病情程度的关系。随访1年,记录120例患者随访期间心血管事件(CVE)的发生情况,将发生CVE的患者纳入CVE组,将未发生CVE的患者纳入非CVE组,比较两组入院时OPG/RANKL、SENP-1、Lp-PLA2水平;采用受试者操作特性(ROC)曲线评估OPG/RANKL、SENP-1、Lp-PLA2预测OSAHS患者CVE发生风险的价值。结果重度组体重指数、颈围、腰围、臀围、RANK、SENP-1、Lp-PLA2高于中度组、轻度组,中度组高于轻度组(P<0.05),OPG、OPG/RANK低于中度组、轻度组,中度组低于轻度组(P<0.05)。多元logistics回归分析结果显示,颈围、颈围、腰围、RANKL、SENP-1、Lp-PLA2高水平是OSAHS患者病情加重的危险因素(OR>1,P<0.05)。OPG、OPG/RANKL高水平是OSAHS患者病情加重的保护因素(OR<1,P<0.05)。CVE组OPG、OPG/RANKL低于非CVE组,RANKL、SENP-1、Lp-PLA2高于非CVE组(P<0.05)。ROC曲线分析结果显示,OPG/RANKL、SENP-1、Lp-PLA2单一及联合检测预测OSAHS患者发生CVE的曲线下面积均>0.70,具有较好预测效能,且联合检测预测效能更高。结论OPG/RANKL、SENP-1、Lp-PLA2水平与OSAHS患者病情严重程度密切相关,并可有效预测OSAHS患者发生CVE的风险。

Objective To analyze the relationship between osteoprotegerin(OPG)/receptor activator of nuclear factor-кB ligand(RANKL),small ubiquitin-like modifi er protein-specifi c protease 1(SENP-1),lipoprotein-associated phospholipase A2(Lp-PLA2)and the severity of obstructive sleep apnea hypopnea syndrome(OSAHS)and its value in predicting cardiovascular events(CVE).Method A prospective study was conducted to select 120 patients with OSAHS who were treated in the hospital from September 2021 to September 2022.The patient’s condition was evaluated according to the’Guidelines for the Diagnosis and Treatment of Obstructive Sleep Apnea Hypopnea Syndrome(Basic Edition)’,and the patients were divided into mild group,moderate group and severe group according to the condition.The baseline data of the patients were counted and compared.Multivariate logistic regression was used to analyze the relationship between OPG/RANKL,SENP-1,Lp-PLA2 and the severity of obstructive OSAHS.The patients were followed up for 1 year,and the occurrence of cardiovascular events(CVE)during the follow-up period was recorded.The patients with CVE were included in the CVE group,and the patients without CVE were included in the non-CVE group.The levels of OPG/RANKL,SENP-1 and Lp-PLA2 at admission were compared between the two groups.Receiver operating characteristic curve(ROC)was used to evaluate the levels of OPG/RANKL,SENP-1 and Lp-PLA2 to predict the risk of CVE in OSAHS patients.Result The body mass index,neck circumference,waist circumference,hip circumference,RANK,SENP-1 and Lp-PLA2 in the severe group were higher than those in the moderate group and the mild group,and the moderate group was higher than the mild group(OR<1,P<0.05).The high levels of OPG and OPG/RANKL were protective factors for the aggravation of OSAHS patients(OR<1,P<0.05).OPG and OPG/RANKL in CVE group were lower than those in non-CVE group,while RANKL,SENP-1 and Lp-PLA2 were higher than those in non-CVE group(P<0.05).The results of ROC curve showed that the AUC of OPG/RANKL,SENP-1,Lp-PLA2 and combined detection of CVE in OSAHS patients were all>0.70,which had good predictive effi cacy,and the combined detection had higher predictive effi cacy.Conclusion The levels of OPG/RANKL,SENP-1 and Lp-PLA2 are closely related to the severity of OSAHS patients,and the three can also effectively predict the risk of CVE in OSAHS patients.