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中国人群中严重阻塞性睡眠呼吸暂停低通气综合征的阿尔茨海默病生物标志物。

Biomarkers of Alzheimer's disease in severe obstructive sleep apnea-hypopnea syndrome in the Chinese population.

机构信息

Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China.

Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5G2M9, Canada.

出版信息

Eur Arch Otorhinolaryngol. 2021 Mar;278(3):865-872. doi: 10.1007/s00405-020-05948-2. Epub 2020 Apr 17.

Abstract

PURPOSE

Patients with severe obstructive sleep apnea-hypopnea syndrome are often accompanied by symptoms such as decreased cognitive function and daytime sleepiness, while cognitive function is often associated with biomarkers of Alzheimer's disease. Therefore, this study aims to explore the level of Alzheimer's disease biomarkers in the plasma of obstructive sleep apnea-hypopnea syndrome patients as well as the relationship between cognitive function and daytime sleepiness.

METHODS

Between May and July 2019, 35 patients requiring hospitalization for severe obstructive sleep apnea-hypopnea syndrome and 16 normal control patients were selected from West China Hospital. Alzheimer's disease biomarkers (Aβ40, Aβ42, t-tau, p-tau) in plasma were detected by ELISA in all 51 subjects. The differences in Alzheimer's disease biomarkers between the two groups were compared. In addition, a correlation analysis of disease-related indicators and univariate analysis of the risk factors of obstructive sleep apnea-hypopnea syndrome was conducted using the logistic regression model.

RESULTS

The plasma levels of Alzheimer's disease biomarkers (Aβ40, t-tau, p-tau) in patients with severe obstructive sleep apnea-hypopnea syndrome were significantly higher than those in the control group (29.24 ± 32.52, 13.18 ± 10.78, p = 0.049; 11.88 ± 7.05, 7.64 ± 4.17, p = 0.037; 26.31 ± 14.41, 17.34 ± 9.12, p = 0.027). Aβ42, Aβ40, t-tau, and p-tau were significantly negatively correlated with mean oxygen saturation, low oxygen saturation and Mini-Mental State examination scale scores, and positively correlated with oxygen desaturation index and Epworth Sleepiness Scale scores. T-tau and p-tau can be used as new risk factors for obstructive sleep apnea-hypopnea syndrome.

CONCLUSION

Alzheimer's disease biomarkers in the plasma of obstructive sleep apnea-hypopnea syndrome patients are higher than those in the control group, and the mechanism of action may be related to sleep disorders and night hypoxia. The Alzheimer's disease biomarkers deposited in plasma may also cause the decline of patients' cognitive function, increased daytime sleepiness and accelerate the progression of obstructive sleep apnea-hypopnea syndrome.

摘要

目的

患有严重阻塞性睡眠呼吸暂停低通气综合征的患者常伴有认知功能下降和日间嗜睡等症状,而认知功能常与阿尔茨海默病的生物标志物相关。因此,本研究旨在探讨阻塞性睡眠呼吸暂停低通气综合征患者血浆中阿尔茨海默病生物标志物的水平以及认知功能与日间嗜睡之间的关系。

方法

2019 年 5 月至 7 月,从华西医院选择了 35 例因严重阻塞性睡眠呼吸暂停低通气综合征而需要住院的患者和 16 例正常对照组患者。采用 ELISA 法检测所有 51 例受试者血浆中的阿尔茨海默病生物标志物(Aβ40、Aβ42、t-tau、p-tau)。比较两组之间阿尔茨海默病生物标志物的差异。此外,采用 logistic 回归模型对疾病相关指标进行单因素分析,并对阻塞性睡眠呼吸暂停低通气综合征的危险因素进行单因素分析。

结果

严重阻塞性睡眠呼吸暂停低通气综合征患者的血浆阿尔茨海默病生物标志物(Aβ40、t-tau、p-tau)水平明显高于对照组(29.24±32.52、13.18±10.78,p=0.049;11.88±7.05、7.64±4.17,p=0.037;26.31±14.41、17.34±9.12,p=0.027)。Aβ42、Aβ40、t-tau 和 p-tau 与平均氧饱和度、低氧饱和度和简易精神状态检查量表评分显著负相关,与氧减指数和 Epworth 嗜睡量表评分显著正相关。t-tau 和 p-tau 可作为阻塞性睡眠呼吸暂停低通气综合征的新危险因素。

结论

阻塞性睡眠呼吸暂停低通气综合征患者血浆中的阿尔茨海默病生物标志物高于对照组,其作用机制可能与睡眠障碍和夜间缺氧有关。沉积在血浆中的阿尔茨海默病生物标志物也可能导致患者认知功能下降、日间嗜睡增加,并加速阻塞性睡眠呼吸暂停低通气综合征的进展。

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