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内脏脂肪特异性丝氨酸蛋白酶抑制剂在阻塞性睡眠呼吸暂停低通气综合征中的意义。

Significance of vaspin in obstructive sleep apnea-hypopnea syndrome.

作者信息

Pan Zhe, Zhuang Xianghua, Li Xiaobo, Huang Shaoyi, Zhang Liang, Lou Fuchen, Chen Shihong, Ni Yihong

机构信息

Department of Endocrinology, The Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China.

出版信息

Exp Ther Med. 2016 Mar;11(3):841-845. doi: 10.3892/etm.2016.2997. Epub 2016 Jan 15.

Abstract

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a commonly-diagnosed chronic sleep disorder. It is considered to be an important independent risk factor in the development of insulin resistance (IR). Patients with OSAHS exhibit a variety of metabolic disorders, including obesity and metabolic syndrome. Visceral adipose tissue-derived serpin (vaspin) is an adipokine that is considered to be a link between obesity and IR. The present study aimed to evaluate the levels of plasma vaspin in patients with OSAHS and examine their potential correlation with sleep characteristics. A total of 20 healthy male subjects and 42 male patients with OSAHS were selected, and patients were divided into mild (n=22) and severe (n=20) OSAHS groups. The 20 patients in the severe OSAHS group received nasal continuous positive airway pressure (nCPAP) treatment for 2 months. Venous blood samples were drawn from all patients in a fasting state prior to and subsequent to nCPAP treatment, which were used to measure the levels of biochemical indicators. The sleep parameters and serologic index changes were compared prior to and following treatment. The values of contractive pressure (SBP), neck circumference (NC), waist circumference (WC), waist-to-hip ratio (WHR), body mass index (BMI) and hip circumference (HC) in the two OSAHS groups were significantly increased compared with those in the control group. In addition, the levels of vaspin in OSAHS patients were markedly increased and vaspin was revealed to be positively associated with fasting blood sugar, fasting insulin, triglycerides, homeostasis model assessment-IR, apnea-hypopnea index (AHI), NC, WC, BMI and WHR (P<0.05). After 2 months of nCPAP treatment, the SBP and AHI were significantly reduced. In conclusion, vaspin may have an important role in OSAHS patients with IR and treatment using nCPAP may improve the condition of OSAHS patients.

摘要

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是一种常见的慢性睡眠障碍。它被认为是胰岛素抵抗(IR)发生发展中的一个重要独立危险因素。OSAHS患者表现出多种代谢紊乱,包括肥胖和代谢综合征。内脏脂肪组织衍生的丝氨酸蛋白酶抑制剂(vaspin)是一种脂肪因子,被认为是肥胖与IR之间的一个联系环节。本研究旨在评估OSAHS患者血浆vaspin水平,并探讨其与睡眠特征的潜在相关性。共选取20名健康男性受试者和42名男性OSAHS患者,将患者分为轻度(n = 22)和重度(n = 20)OSAHS组。重度OSAHS组的20名患者接受了2个月的鼻持续气道正压通气(nCPAP)治疗。在nCPAP治疗前后,对所有患者在空腹状态下采集静脉血样,用于检测生化指标水平。比较治疗前后的睡眠参数和血清学指标变化。与对照组相比,两个OSAHS组的收缩压(SBP)、颈围(NC)、腰围(WC)、腰臀比(WHR)、体重指数(BMI)和臀围(HC)值均显著升高。此外,OSAHS患者的vaspin水平明显升高,且vaspin与空腹血糖、空腹胰岛素、甘油三酯、稳态模型评估-IR、呼吸暂停低通气指数(AHI)、NC、WC、BMI和WHR呈正相关(P < 0.05)。经过2个月的nCPAP治疗后,SBP和AHI显著降低。总之,vaspin可能在伴有IR的OSAHS患者中起重要作用,使用nCPAP治疗可能改善OSAHS患者的病情。

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