Chair and Department of Pulmonology and Lung Cancer, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2013 Nov-Dec;22(6):817-24.
BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a frequent disease, characterized by repetitive episodes of upper airway obstruction during sleep, leading to many pathological events. Adiponectin is an adipocyte-specific secreted protein that plays a role in glucose and lipid homeostasis, in addition to antiatherogenic and anti-diabetic effects. Bioelectrical impedance analysis (BIA) is a reliable, non-invasive, safe and effective technique to measure body composition. OBJECTIVES: The aim of the study was the evaluation of body composition and adiponectin serum levels in OSAS patients and their comparison with OSAS parameters as well as with C-reactive protein (CRP) and cholesterol levels. MATERIAL AND METHODS: In this study, 137 patients with OSAS and 42 persons for the control group were enrolled. In the examined group with OSAS, there were 100 males (73%) and 37 females (27%). The average age was 54.37 + 9.8 years. All subjects underwent polysomnography with Grass Aura PSG Lite and bioelectrical impedance analysis (BIA) with a single-frequency bioimpedance analyzer (Model BIA 101, AKERN-RJL, Italy). The adiponectin serum level was measured using a sandwich ELISA kit. RESULTS: In OSAS patients we demonstrated a higher body mass index (BMI) and percentage of extracellular water (ECW%) and lower percentage of intracellular water (ICW%) and phase angle. Moreover, severe OSAS and control comparison revealed a lower percentage of muscle mass (MM%) in severe OSAS. Positive correlations were found between the apnea-hypopnea index (AHI) and BMI, CRP and ECW%. Negative correlations were observed between AHI and ICW%, MM% and phase angle. We found neither differences in adiponectin levels between the control group and OSAS patients nor correlations between adiponectin and body composition parameters. But we showed that adiponectin levels were significantly lower in OSAS patients with diabetes than in OSAS patients without diabetes (2.64 vs. 13.46 µg/mL, p = 0.003). In OSAS patients without diabetes, we revealed many negative correlations between adiponectin levels and the body composition parameters (including phase angle, percentage of total body water - TBW%, ICW%, percentage of fat free mass - FFM% and MM%) and triglycerides. The positive relationships were between adiponectin and CRP, ECW% and percentage of fat mass (FM%). CONCLUSIONS: Our results indicate that in OSAS patients there are many changes in body composition. The most interesting are higher BMI, TBW% and ECW% and lower BCM%, IW%, MM% and phase angle. Our results suggest that OSAS does not influence adiponectin level, but adiponectin levels are lower in patients with diabetes. Adiponectin levels correlate with many body composition parameters in OSAS patients without diabetes.
背景：阻塞性睡眠呼吸暂停综合征（OSAS）是一种常见疾病，其特征是睡眠期间上呼吸道反复阻塞，导致许多病理事件。脂联素是一种脂肪细胞特异性分泌的蛋白质，除了具有抗动脉粥样硬化和抗糖尿病作用外，还在葡萄糖和脂质稳态中发挥作用。生物电阻抗分析（BIA）是一种可靠、无创、安全、有效的测量身体成分的技术。
目的：本研究旨在评估 OSAS 患者的身体成分和脂联素血清水平，并将其与 OSAS 参数以及 C 反应蛋白（CRP）和胆固醇水平进行比较。
材料和方法：本研究纳入了 137 例 OSAS 患者和 42 名对照组患者。在 OSAS 组中，有 100 名男性（73%）和 37 名女性（27%）。平均年龄为 54.37 + 9.8 岁。所有受试者均接受 Grass Aura PSG Lite 多导睡眠图和单频生物阻抗分析仪（Model BIA 101，AKERN-RJL，意大利）进行生物电阻抗分析（BIA）。使用夹心 ELISA 试剂盒测量脂联素血清水平。
结果：在 OSAS 患者中，我们发现体重指数（BMI）和细胞外液百分比（ECW%）较高，细胞内液百分比（ICW%）和相位角较低。此外，与对照组相比，严重 OSAS 患者的肌肉质量百分比（MM%）较低。呼吸暂停-低通气指数（AHI）与 BMI、CRP 和 ECW%呈正相关。AHI 与 ICW%、MM%和相位角呈负相关。我们发现对照组和 OSAS 患者之间的脂联素水平没有差异，也没有发现脂联素与身体成分参数之间的相关性。但我们发现，与无糖尿病的 OSAS 患者相比，患有糖尿病的 OSAS 患者的脂联素水平明显较低（2.64 与 13.46 µg/mL，p = 0.003）。在无糖尿病的 OSAS 患者中，我们发现脂联素水平与身体成分参数（包括相位角、总体水百分比-TBW%、ICW%、无脂肪质量百分比-FFM%和 MM%）和甘油三酯之间存在许多负相关关系。正相关关系存在于脂联素与 CRP、ECW%和脂肪质量百分比（FM%）之间。
结论：我们的结果表明，OSAS 患者的身体成分有许多变化。最有趣的是 BMI、TBW%和 ECW%较高，而 BCM%、IW%、MM%和相位角较低。我们的结果表明，OSAS 不会影响脂联素水平，但糖尿病患者的脂联素水平较低。在无糖尿病的 OSAS 患者中，脂联素水平与身体成分参数相关。
Zhonghua Yi Xue Za Zhi. 2014-2-18
Clin Endocrinol (Oxf). 2006-1
Blood Coagul Fibrinolysis. 2013-6
Zotero 插件