Chen Jun-Tao, Zhang Ping, Kong Xiao-Yi, Ge Yi-Jun, Li Xue-Yan, Yang Shuai, He Shuo, Chen Gui-Hai
Department of Neurology (Sleep Disorder), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), 238000, Anhui Province, People's Republic of China.
Department of Neurology (Sleep Disorder), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), 238000, Anhui Province, People's Republic of China.
Sleep Med. 2022 Mar;91:96-104. doi: 10.1016/j.sleep.2022.02.017. Epub 2022 Feb 28.
Epidemiological and observational clinical studies have found that insomnia is a risk factor for stroke and that, accordingly, insomnia is likely to cause changes of stroke-related biomarkers. There is substantial evidence that stroke is closely related to endothelial dysfunction and hypertension. The aim of this study is to investigate whether there is alteration of endothelial dysfunction (CD62E) and hypertension (angiotensin II and copeptin) biomarkers in patients with chronic insomnia disorder (CID).
The CID patients (N = 54) and the good sleepers (GS, N = 32) were enrolled. Pittsburgh sleep quality index (PSQI), pre-sleep arousal scale (PSAS) and polysomnography were used to assess their sleep and neuropsychological function. Serum levels of CD62E, angiotensin II and copeptin were determined using a quantitative sandwich ELISA.
The CID group had higher serum levels of CD62E, angiotensin II, and copeptin than the GS group. After controlling for sex, age, depression and apnea-hypopnea index, the partial correlation analysis revealed that the levels of CD62E and copeptin correlated positively with the PSAS score and negatively with the objective sleep quality. Angiotensin II levels negatively correlated with objective sleep onset latency. Moreover, there was a positive correlation between CD62E and angiotensin II. Principal components analysis revealed that CD62E and copeptin had a substantial correlation with parameters of subjective and objective sleep.
Patients with CID exhibit endothelial activation, over-activated renin-angiotensin system and increased sympathetic excitability, as indicated by increased serum levels of CD62E, angiotensin II and copeptin, with linking to poor sleep quality.
流行病学和观察性临床研究发现，失眠是中风的一个危险因素，因此，失眠可能会导致中风相关生物标志物的变化。有大量证据表明，中风与内皮功能障碍和高血压密切相关。本研究的目的是调查慢性失眠障碍（CID）患者的内皮功能障碍（CD62E）和高血压（血管紧张素II和 copeptin）生物标志物是否存在改变。
招募了CID患者（N = 54）和睡眠良好者（GS，N = 32）。使用匹兹堡睡眠质量指数（PSQI）、睡前觉醒量表（PSAS）和多导睡眠图来评估他们的睡眠和神经心理功能。使用定量夹心ELISA法测定血清中CD62E、血管紧张素II和copeptin的水平。
CID组的血清CD62E、血管紧张素II和copeptin水平高于GS组。在控制了性别、年龄、抑郁和呼吸暂停低通气指数后，偏相关分析显示，CD62E和copeptin水平与PSAS评分呈正相关，与客观睡眠质量呈负相关。血管紧张素II水平与客观入睡潜伏期呈负相关。此外，CD62E与血管紧张素II之间存在正相关。主成分分析显示，CD62E和copeptin与主观和客观睡眠参数有显著相关性。
CID患者表现出内皮激活、肾素-血管紧张素系统过度激活和交感神经兴奋性增加，血清CD62E、血管紧张素II和copeptin水平升高表明了这一点，且与睡眠质量差有关。
