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中国成年人循环中增殖诱导配体(APRIL)水平与阻塞性睡眠呼吸暂停严重程度之间的关联。

The association between circulating APRIL levels and severity of obstructive sleep apnea in Chinese adults.

作者信息

Wen Wan-Wan, Sun Hai-Li, Yang Yun-Xiao, Jia Yi-Fan, Huang Meng-Ling, Du Yun-Hui, Qin Yan-Wen, Fang Fang, Zhang Ming, Wei Yong-Xiang

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Department of Otolaryngology Head & Neck Surgery, Key Laboratory of Upper Airway Dysfunction-related Cardiovascular Diseases, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

Clin Chim Acta. 2020 Sep;508:161-169. doi: 10.1016/j.cca.2020.05.028. Epub 2020 May 14.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) is the most common type of sleep breathing disorder and is characterized by chronic intermittent hypoxia, which could cause inflammation and nuclear factor kappa B (NF-KB)-dependent inflammatory pathways activation. Circulating APRIL (a proliferation-inducing ligand) play an important role in promoting inflammation and NF-KB-dependent inflammatory pathways activation. We explored the role of APRIL as a potential mechanism of inflammation in OSA patients.

METHODS

After detailed sleep evaluated, venous blood and demographic data were collected from 155 subjects with varying severity of OSA and 52 control subjects. Plasma levels of APRIL were measured by human Magnetic Luminex assay.

RESULTS

Plasma APRIL levels were significantly higher in OSA subjects compared with control subjects. Categorization of the OSA subjects into mild, moderate, and severe OSA subgroups found that plasma levels of APRIL increased with the severity of OSA. After adjusting confounding factors, found that increased plasma APRIL levels were conferred a higher odds ratio of OSA. Moreover, plasma APRIL levels were positively associated with the apnea-hypopnea index, which represents the severity of OSA. Furthermore, plasma APRIL showed higher discriminatory accuracy in predicting the presence of OSA.

CONCLUSIONS

Plasma APRIL levels were significantly associated with the occurrence of OSA and its severity. APRIL could be a plasma biomarker with a positive diagnostic value for inflammation and NF-KB-dependent inflammatory pathways activation in subjects with OSA.

TRIAL REGISTRATION

The project was approved by the Chinese Clinical Trial Registry (No. ChiCTRROC-17011027).

摘要

背景

阻塞性睡眠呼吸暂停(OSA)是最常见的睡眠呼吸障碍类型,其特征为慢性间歇性缺氧,可导致炎症及核因子κB(NF-κB)依赖性炎症途径激活。循环中的增殖诱导配体(APRIL)在促进炎症及NF-κB依赖性炎症途径激活中起重要作用。我们探讨了APRIL作为OSA患者炎症潜在机制的作用。

方法

在进行详细的睡眠评估后,从155例不同严重程度的OSA患者和52例对照者中收集静脉血及人口统计学数据。采用人磁珠免疫分析方法测定血浆APRIL水平。

结果

与对照者相比,OSA患者的血浆APRIL水平显著更高。将OSA患者分为轻度、中度和重度OSA亚组,发现血浆APRIL水平随OSA严重程度增加而升高。在调整混杂因素后,发现血浆APRIL水平升高使OSA的比值比更高。此外,血浆APRIL水平与呼吸暂停低通气指数呈正相关,该指数代表OSA的严重程度。此外,血浆APRIL在预测OSA的存在方面显示出更高的判别准确性。

结论

血浆APRIL水平与OSA的发生及其严重程度显著相关。APRIL可能是一种对OSA患者炎症及NF-κB依赖性炎症途径激活具有阳性诊断价值的血浆生物标志物。

试验注册

该项目已获得中国临床试验注册中心批准(注册号:ChiCTRROC-17011027)。

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