Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
Respir Med. 2020 Mar;163:105881. doi: 10.1016/j.rmed.2020.105881. Epub 2020 Jan 28.
Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for cardiovascular disease (CVD). As a new inflammatory biomarker of CVD, rare attention has been paid to the roles of lipoprotein-associated phospholipase (Lp-PLA2) in OSAS studies. In this study, we aimed to investigate the correlation between Lp-PLA2 and concomitant CVD in OSAS patients.
In this prospective study, 152 OSAS patients were further divided into mild, moderate, and severe OSAS subgroups. They presented heart failure, coronary artery disease, or arrhythmia were confirmed with CVD. Thirty-one subjects without OSAS were recruited for the control group. The relationship between Lp-PLA2 and concomitant CVD in OSAS patients was analyzed.
Serum Lp-PLA2 values were significantly higher in the severe and moderate OSAS group compared with mild OSAS and OSAS negative groups (P = 0.025). Significant increase was noticed in serum Lp-PLA2 levels in CVD patients compared with those without in severe-moderate-mild OSAS (P < 0.05). In logistic regression analysis, the level of Lp-PLA2 was proved as a significant independent predictor for CVD (OR = 1.117, P = 0.008). The ROC analysis indicated that the best cut-off value of Lp-PLA2 for predicting CVD in OSAS patients was 238.09 ng/ml. The positive and negative predictive values were 72.5% and 70.5%, respectively. The sensitivity was 46.8% and the specificity was 87.8%.
Lp-PLA2 might be associated with the severity of OSAS and the occurrence of CVD in OSAS patients. Lp-PLA2 is expected to be a promising biomarker candidate in predicting CVD in patients with OSAS due to test convenience.
阻塞性睡眠呼吸暂停综合征（OSAS）是心血管疾病（CVD）的独立危险因素。脂蛋白相关磷脂酶（Lp-PLA2）作为心血管疾病的一种新的炎症生物标志物，在 OSAS 研究中很少受到关注。本研究旨在探讨 Lp-PLA2 与 OSAS 患者并发 CVD 的相关性。
在这项前瞻性研究中，152 例 OSAS 患者进一步分为轻度、中度和重度 OSAS 亚组。患有心力衰竭、冠状动脉疾病或心律失常的患者被确诊为 CVD。招募了 31 名无 OSAS 的受试者作为对照组。分析了 OSAS 患者中 Lp-PLA2 与并发 CVD 的关系。
重度和中度 OSAS 组患者血清 Lp-PLA2 值明显高于轻度 OSAS 组和 OSAS 阴性组（P=0.025）。与轻度 OSAS 患者相比，重度-中度-轻度 OSAS 患者中 CVD 患者的血清 Lp-PLA2 水平显著升高（P<0.05）。在逻辑回归分析中，Lp-PLA2 水平被证明是 CVD 的显著独立预测因子（OR=1.117，P=0.008）。ROC 分析表明，Lp-PLA2 预测 OSAS 患者 CVD 的最佳截断值为 238.09ng/ml。阳性预测值和阴性预测值分别为 72.5%和 70.5%。敏感性为 46.8%，特异性为 87.8%。
Lp-PLA2 可能与 OSAS 的严重程度和 OSAS 患者 CVD 的发生有关。由于检测方便，Lp-PLA2 有望成为预测 OSAS 患者 CVD 的有前途的生物标志物候选物。
