Unit of Internal Medicine "Guido Baccelli", Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro Medical School, Piazza Giulio Cesare 11, I-70124 Bari, BA, Italy.
Respiratory Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Bari, BA, Italy.
Sleep Med. 2021 Jun;82:117-124. doi: 10.1016/j.sleep.2021.03.039. Epub 2021 Apr 9.
Galectin-3, considered as a new inflammatory marker; it is increased in cardiovascular disease. We investigated Galectin-3 in relation to heart damage in patients with OSA and its role in inflammation, based on the Neutrophil-to-Lymphocyte Ratio (NLR).
Sixty-three consecutive patients (45 males, 18 females, 58.60 ± 12.28 years old) were studied. According to the Apnoea-Hypopnoea Index (AHI) patients were divided into Group 1 - non-severe (AHI <30) (17 males and 10 females, 59.89 ± 10.62 years old) and Group 2 - severe (AHI ≥30) (29 males and 6 females, aged 57.53 ± 13.30 years old) OSA. All patients underwent morning blood gas analysis, laboratory tests, nocturnal polygraphy, and echocardiography.
Galectin-3 was significantly increased in Group 2 (p = 0.027) patients. Moreover, it was directly related to left ventricle (LV) mass, left ventricle hypertrophy and LV posterior wall diameter. Tissue Doppler septal velocity (e'), that measures wall motion, was inversely correlated to Galectin-3. Furthermore, a direct association to diastolic dysfunction, evaluated as E/e' ratio, was observed. In line with these data, a direct correlation between Galectin-3 and left atrium volume was also found. Galectin-3 and percentage of total registration time with nocturnal oxygen saturation <90% (TST90) were directly correlated (p = 0.0003), while Galectin-3 and mean nocturnal SpO were negatively correlated (p = 0.0045). We found a direct correlation between Galectin-3 and NLR (p = 0.011). Finally, Galectin-3 was able to predict 3-yr mortality with a specificity of 83.33% and a sensitivity of 91.84%.
Galectin-3 showed a direct association to nocturnal respiratory indices and to cardiac remodelling in patients with OSA. OSA-induced inflammation may play an important role in the pathogenesis of heart damage.
半乳糖凝集素-3 被认为是一种新的炎症标志物，在心血管疾病中会增加。我们根据中性粒细胞与淋巴细胞比值（NLR）研究了半乳糖凝集素-3 与 OSA 患者心脏损伤的关系及其在炎症中的作用。
研究了 63 例连续患者（45 名男性，18 名女性，58.60±12.28 岁）。根据呼吸暂停-低通气指数（AHI），患者分为 1 组 - 非重度（AHI<30）（17 名男性和 10 名女性，59.89±10.62 岁）和 2 组 - 重度（AHI≥30）（29 名男性和 6 名女性，年龄 57.53±13.30 岁）OSA。所有患者均进行了晨间血气分析、实验室检查、夜间多导睡眠图和超声心动图检查。
2 组患者的半乳糖凝集素-3 明显升高（p=0.027）。此外，它与左心室（LV）质量、左心室肥厚和 LV 后壁直径直接相关。评估壁运动的组织多普勒室间隔速度（e'）与半乳糖凝集素-3 呈负相关。此外，还观察到与舒张功能障碍的直接相关性，表现为 E/e'比值。与这些数据一致，还发现半乳糖凝集素-3 与左心房容积之间存在直接相关性。半乳糖凝集素-3 与夜间血氧饱和度<90%的总记录时间百分比（TST90）呈直接相关（p=0.0003），而半乳糖凝集素-3 与平均夜间 SpO2呈负相关（p=0.0045）。我们发现半乳糖凝集素-3 与 NLR 呈直接相关（p=0.011）。最后，半乳糖凝集素-3 能够以 83.33%的特异性和 91.84%的敏感性预测 3 年死亡率。
半乳糖凝集素-3 与 OSA 患者的夜间呼吸指数和心脏重构直接相关。OSA 引起的炎症可能在心脏损伤的发病机制中起重要作用。
