The Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Beijing, 100029, China.
Department of Sleep Medical Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China.
Lipids Health Dis. 2019 Jan 26;18(1):30. doi: 10.1186/s12944-019-0973-z.
BACKGROUND: The relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and a variety of disease from obesity, type 2 diabetes mellitus and cardiovascular disease has been investigated previously. Reduced adiponectin levels are also associated with increased risk of these disease. However, whether serum/plasma adiponectin levels in OSAHS patients are lower than their counterparts remain controversial. Therefore, this study evaluated the association between serum/plasma adiponectin levels and OSAHS. METHODS: We performed a comprehensive literature search to locate eligible articles published on electronic databases including PubMed, EMBASE, Cochrane Library, WANFANG (Chinese database), VIP (Chinese Database) and Chinese National Knowledge Infrastructure (CNKI). The methodological quality of included studies was evaluated using the Newcastle-Ottawa scale (NOS). Pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated as effect size. Heterogeneity test was performed by Cochrane Q test and I test. Subgroup analysis and meta-regression analysis were employed to detect the sources of the heterogeneity. RevMan 5.3 and Stata 12.0 software were used in this meta-analysis for data synthesis. RESULTS: A total of 20 eligible studies with 28 databases involving 1356 participants were included in this meta-analysis. Results revealed that serum/plasma adiponectin levels in OSAHS patients were significantly lower than that in controls [SMD = - 0.71, 95% CI = - 0.92 to - 0.49, p < 0.001]. Subgroup analysis indicated that the heterogeneity would decreased when subgroup analysis was stratified by race. In addition, meta-regression analysis also suggested that the adiponectin levels were only significantly correlated with race. The removal of any independent study did not affect the pooled SMD in the sensitivity analysis. CONCLUSION: The serum/plasma adiponectin levels were significantly lower in OSAHS patients than that in control subjects, suggesting a possible role of adiponectin in OSAHS pathogenesis, deserves further studies as a potential marker of OSAHS.
背景：阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与肥胖、2 型糖尿病和心血管疾病等多种疾病的关系此前已有研究。脂联素水平降低与这些疾病的风险增加也有关。然而，OSAHS 患者的血清/血浆脂联素水平是否低于对照组仍存在争议。因此，本研究评估了血清/血浆脂联素水平与 OSAHS 之间的关系。
方法：我们进行了全面的文献检索，以定位发表在电子数据库中的符合条件的文章，包括 PubMed、EMBASE、Cochrane 图书馆、万方（中文数据库）、维普（中文数据库）和中国国家知识基础设施（CNKI）。使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的方法学质量。采用合并标准均数差（SMD）及其 95%置信区间（CI）作为效应量。采用 Cochrane Q 检验和 I 检验进行异质性检验。采用亚组分析和 meta 回归分析来检测异质性的来源。本 meta 分析使用 RevMan 5.3 和 Stata 12.0 软件进行数据合成。
结果：本 meta 分析共纳入 20 项研究，涉及 28 个数据库，共 1356 名参与者。结果表明，OSAHS 患者的血清/血浆脂联素水平显著低于对照组[SMD=-0.71，95%CI=-0.92 至-0.49，p<0.001]。亚组分析表明，按种族分层时，异质性会降低。此外，meta 回归分析还表明，脂联素水平仅与种族显著相关。敏感性分析中去除任何一项独立研究均未影响合并 SMD。
结论：OSAHS 患者的血清/血浆脂联素水平明显低于对照组，提示脂联素在 OSAHS 发病机制中可能起作用，作为 OSAHS 的潜在标志物值得进一步研究。
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