Department of Pulmonary Medicine, Erciyes University School of Medicine, Kayseri, Turkey.
Respir Med. 2011 Apr;105(4):637-42. doi: 10.1016/j.rmed.2010.12.003. Epub 2010 Dec 23.
Gamma glutamyl transferase (GGT) is a new marker for predicting myocardial infarction, stroke, cardiac death and inflammation. There is also a strong relationship between Obstructive Sleep Apnea Syndrome (OSAS) and cardiovascular disease. This study was designed to investigate the association between serum GGT levels and cardiovascular disease in patients with OSAS, and relationship between severity of OSAS and serum GGT level. We evaluated the medical records of 166 subjects who were admitted for sleep study. OSAS was diagnosed by polysomnography if Apnea-Hypopnea Index (AHI) > 5. According to AHI, individuals in whom AHI< 5 were recruited as group 1 (OSAS negative group), AHI = 5-15: group 2 (mild OSAS group), AHI = 15-30: group 3 (moderate OSAS group), AHI >30: group 4 (severe OSAS group). Cardiovascular disease was defined if the patients had heart failure, coronary artery disease or arrhythmia. Of the subjects, 112 (67.5%) were male and the mean age was 54.3 ± 12.2 years. There were 22 patients (13.2%), 17 patients (10.2%), 34 patients (20.4%) and 93 patients (56.2%) in group 1, 2, 3 and 4, respectively. There is a significant increase in serum GGT levels while AHI score increases (group 1 = 28.0 ± 10.1, group 2 = 33.8 ± 13.2, group 3 = 35.2 ± 8.5, group 4 = 40.0 ± 22.0; p for trend = 0.024). However, serum C-reactive protein (CRP), alanine aminotransferase and aspartate aminotransferase levels were similar in all groups (p > 0.05). There was a significant independent association between serum GGT levels and the severity of OSAS. Moreover, serum GGT levels were significantly high in patients with cardiovascular disease compared with patients without cardiovascular disease in severe-moderate-mild OSAS (p < 0.05) and OSAS negative groups while CRP levels were not. This was a significant independent association. The present study suggests that high serum GGT level, regardless of the other traditional risk factors, is an independent predictor of cardiovascular disease in patients with OSAS. The results should be confirmed with other randomized prospective studies.
γ-谷氨酰转移酶（GGT）是预测心肌梗死、中风、心源性死亡和炎症的新标志物。阻塞性睡眠呼吸暂停综合征（OSAS）与心血管疾病之间也存在很强的关联。本研究旨在探讨 OSAS 患者血清 GGT 水平与心血管疾病之间的关系，以及 OSAS 严重程度与血清 GGT 水平之间的关系。我们评估了 166 名因睡眠研究而入院的患者的病历。如果呼吸暂停低通气指数（AHI）>5，则通过多导睡眠图诊断为 OSAS。根据 AHI，将 AHI<5 的个体纳入第 1 组（OSAS 阴性组），AHI=5-15：第 2 组（轻度 OSAS 组），AHI=15-30：第 3 组（中度 OSAS 组），AHI>30：第 4 组（重度 OSAS 组）。如果患者有心衰、冠状动脉疾病或心律失常，则定义为心血管疾病。在这些患者中，有 112 名（67.5%）为男性，平均年龄为 54.3±12.2 岁。分别在第 1、2、3 和 4 组中发现了 22 例（13.2%）、17 例（10.2%）、34 例（20.4%）和 93 例（56.2%）患者。随着 AHI 评分的增加，血清 GGT 水平显著升高（第 1 组=28.0±10.1，第 2 组=33.8±13.2，第 3 组=35.2±8.5，第 4 组=40.0±22.0；趋势 p 值=0.024）。然而，各组的血清 C 反应蛋白（CRP）、丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平相似（p>0.05）。血清 GGT 水平与 OSAS 的严重程度存在显著的独立相关性。此外，与无心血管疾病的患者相比，在中重度 OSAS 患者（p<0.05）和 OSAS 阴性患者中，心血管疾病患者的血清 GGT 水平显著升高，而 CRP 水平则没有。这是一个显著的独立关联。本研究表明，无论其他传统危险因素如何，高血清 GGT 水平是 OSAS 患者心血管疾病的独立预测因子。该结果需要通过其他随机前瞻性研究来证实。
