Tokuda Fumie, Sando Yoshichika, Matsui Hiroki, Koike Hiroto, Yokoyama Tomoyuki
Department of Laboratory Science, Gunma Univercity School of Health Sciences, Maebashi.
Intern Med. 2008;47(21):1843-9. doi: 10.2169/internalmedicine.47.1035. Epub 2008 Nov 4.
Obstructive sleep apnea syndrome (OSAS) is frequently complicated by metabolic syndrome, including diabetes and hypertension. Both OSAS and metabolic syndrome are strongly associated with obesity. Recently, adiponectin and leptin, which are secreted by adipose tissue, have been considered to play important roles in the progression of these diseases. Thus, to examine the association between leptin, adiponectin and OSAS, we measured the serum level of these adipocytokines in the same OSAS patients.
Sixty-eight consecutive Japanese men, who recorded all-night polysomnography, were enrolled in this study, and were divided into three groups, control (n=15), moderate OSAS (n=21) and severe OSAS (n=32). We measured serum levels of adiponectin and leptin by ELISA.
Serum leptin levels were positively correlated with apnea hypopnea index (AHI) (r=0.552, p<0.001), the percentage of time with less than 90% hemoglobin saturation level in total sleep time (%T<90) (r=0.399, p<0.001) and body mass index (BMI) (r=0.807, p<0.0001). These parameters were suggested as the determinant factor for the serum leptin level by stepwise multiple regression analysis. On the other hand, serum adiponectin levels showed a positive correlation with age (r=0.361, p=0.005) and HDL-cholesterol level (r=0.274, p=0.039). Although there was no significant correlation between serum adiponectin levels and AHI or %T<90, serum adiponectin levels were chosen at a determinant factor of %T<90.
These results suggested that the increasing severity of OSAS induces an increase in setum leptin concentration, but the serum adiponectin levels may be regulated independently of the degree of OSAS, obesity and serum leptin levels in patients with OSAS.
阻塞性睡眠呼吸暂停综合征(OSAS)常并发代谢综合征,包括糖尿病和高血压。OSAS和代谢综合征均与肥胖密切相关。近来,脂肪组织分泌的脂联素和瘦素被认为在这些疾病的进展中起重要作用。因此,为研究瘦素、脂联素与OSAS之间的关联,我们检测了同一组OSAS患者血清中这些脂肪细胞因子的水平。
连续纳入68名记录了整夜多导睡眠图的日本男性,将其分为三组:对照组(n = 15)、中度OSAS组(n = 21)和重度OSAS组(n = 32)。我们采用酶联免疫吸附测定法(ELISA)检测血清脂联素和瘦素水平。
血清瘦素水平与呼吸暂停低通气指数(AHI)呈正相关(r = 0.552,p < 0.001),与总睡眠时间中血红蛋白饱和度低于90%的时间百分比(%T<90)呈正相关(r = 0.399,p < 0.001),与体重指数(BMI)呈正相关(r = 0.807,p < 0.0001)。通过逐步多元回归分析,这些参数被认为是血清瘦素水平的决定因素。另一方面,血清脂联素水平与年龄呈正相关(r = 0.361,p = 0.005),与高密度脂蛋白胆固醇水平呈正相关(r = 0.274,p = 0.039)。虽然血清脂联素水平与AHI或%T<90之间无显著相关性,但血清脂联素水平被选为%T<90的一个决定因素。
这些结果表明,OSAS严重程度的增加会导致血清瘦素浓度升高,但OSAS患者血清脂联素水平可能独立于OSAS程度、肥胖及血清瘦素水平而受到调节。