Department of Respiratory Medicine, Xiangya Hospital (Key Cite of National Clinical Research Center for Respiratory Disease), Central South University, Changsha, 410008, Hunan, China.
Hunan Chest Hospital, Changsha, 410000, Hunan, China.
Sleep Breath. 2021 Mar;25(1):117-123. doi: 10.1007/s11325-020-02072-7. Epub 2020 Apr 6.
OBJECTIVE: Adropin is a recently discovered peptide hormone that plays a vital role in metabolism and cardiovascular-cerebrovascular function. The purpose of this study is to investigate the role of circulating adropin levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and further determine the relationship between serum adropin concentration and endothelial dysfunction in patients with OSAHS. METHODS: Forty polysomnography-diagnosed patients with OSAHS and 21 age and sex-matched healthy controls were enrolled in the current study. Serum adropin level, endothelial function parameters including flow-mediated dilatation (FMD) of brachial artery, endothelin-1 (ET-1), and nitric oxide (NO) were measured in all participants. RESULTS: Serum adropin levels were significantly lower in patients with OSAHS compared to the control subjects. FMD was lower and serum ET-1 levels were higher in patients with OSAHS compared to control subjects. No significant difference was seen in serum NO levels between the two groups. Multivariate linear regression analysis revealed that serum adropin level was positively associated with FMD and negatively correlated with AHI. Additionally, serum adropin levels were lower in patients with OSAHS who had endothelial dysfunction compared with those patients without endothelial dysfunction. The receiver operating characteristic (ROC) analysis showed that area under the curve (AUC) for serum adropin in predicting endothelial dysfunction status in patients with OSAHS was 0.815 (95% CI 0.680-0.951, p = 0.001). The cutoff value of serum adropin level was less than 235.0 pg/mL, which provided the sensitivity and specificity of 81% and 75%, respectively, for the detection of endothelial dysfunction in patients with OSAHS. CONCLUSION: Lower circulating adropin levels are closely associated with endothelial dysfunction in patients with OSAHS. Circulating adropin level may serve as an early biomarker to predict the development of endothelial dysfunction before the emergence of clinical symptoms in patients with OSAHS.
目的：阿多品是一种新发现的肽类激素，在代谢和心血管-脑血管功能中起着至关重要的作用。本研究旨在探讨循环阿多品水平在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者中的作用，并进一步确定 OSAHS 患者血清阿多品浓度与内皮功能障碍的关系。
方法：本研究纳入了 40 名经多导睡眠图诊断为 OSAHS 的患者和 21 名年龄和性别匹配的健康对照者。所有参与者均测量了血清阿多品水平、内皮功能参数，包括肱动脉血流介导的扩张（FMD）、内皮素-1（ET-1）和一氧化氮（NO）。
结果：与对照组相比，OSAHS 患者的血清阿多品水平显著降低。与对照组相比，OSAHS 患者的 FMD 较低，血清 ET-1 水平较高。两组间血清 NO 水平无显著差异。多元线性回归分析显示，血清阿多品水平与 FMD 呈正相关，与 AHI 呈负相关。此外，与无内皮功能障碍的 OSAHS 患者相比，有内皮功能障碍的 OSAHS 患者的血清阿多品水平较低。受试者工作特征（ROC）分析显示，血清阿多品预测 OSAHS 患者内皮功能障碍状态的曲线下面积（AUC）为 0.815（95%CI 0.680-0.951，p=0.001）。血清阿多品水平的截断值小于 235.0 pg/mL，对 OSAHS 患者内皮功能障碍的检测具有 81%的敏感性和 75%的特异性。
结论：较低的循环阿多品水平与 OSAHS 患者的内皮功能障碍密切相关。循环阿多品水平可能成为预测 OSAHS 患者出现临床症状前内皮功能障碍发展的早期生物标志物。
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