Ge Tiantian, Song Songsong, Li Shengnan, Yu Xiaojin, Shao Liangfa, Tong Jiayi
Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Cardiovasc Diagn Ther. 2023 Dec 15;13(6):994-1002. doi: 10.21037/cdt-23-323. Epub 2023 Dec 6.
Obstructive sleep apnea syndrome (OSAS) combined with heart failure (HF) has become a serious disease that threatens human health. Therapeutic interventions targeting OSAS have been shown to improve outcomes in patients with HF, so the identification of severe OSAS in HF is critical. Carbohydrate antigen 125 (CA125) is associated with inflammation and volume overload. The levels of CA125 are elevated in the serum of patients with HF and might be further elevated in patients with HF and OSAS. The aim of this study was to measure CA125 levels in patients with HF with and without OSAS and to analyze affecting factors.
In this single-center retrospective cohort study, a total of 95 patients diagnosed with HF hospitalized in Zhongda Hospital from April 2021 to April 2022 were recruited, including 55 patients with OSAS and 40 patients without OSAS. Participants with a history of central sleep apnea syndrome, severe chronic obstructive pulmonary disease, tumors, severe infection, or who were pregnant were excluded. The histories of the participants were recorded, and laboratory examinations were performed. Binary logistic regression analysis was performed to determine the relationship between serum CA125 levels and OSAS in patients with HF.
The serum CA125 levels were higher in the HF + OSAS group than in the HF group (29.60 9.68 U/mL, P<0.001). According to the univariate analysis, CA125 (>35 U/mL) was significantly related to pleural effusion, acute HF, apnea-hypopnea index (AHI), left ventricular ejection fraction (LVEF) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Finally, the AHI demonstrated statistical significance in multiple analyses (OR 1.070, 95% CI: 1.019-1.124, P=0.006). Spearman rank correlation coefficient analysis showed that CA125 was positively correlated with AHI, and Ln(CA125) (Ln is the natural logarithm based on e) gradually increased with increasing AHI (r=0.551, P<0.0001).
The levels of CA125 were further increased in patients with HF and OSAS, and CA125 (>35 U/mL) was positively correlated with AHI. As a biomarker associated with inflammation and congestion, serum CA125 may have certain value in the diagnosis of patients with HF combined with OSAS.
阻塞性睡眠呼吸暂停综合征（OSAS）合并心力衰竭（HF）已成为威胁人类健康的严重疾病。针对OSAS的治疗干预已被证明可改善HF患者的预后，因此识别HF患者中的重度OSAS至关重要。糖类抗原125（CA125）与炎症和容量超负荷相关。HF患者血清中CA125水平升高，在合并OSAS的HF患者中可能进一步升高。本研究旨在测量合并和未合并OSAS的HF患者的CA125水平，并分析影响因素。
在这项单中心回顾性队列研究中，共纳入2021年4月至2022年4月在中大医院住院的95例确诊为HF的患者，其中55例合并OSAS，40例未合并OSAS。排除有中枢性睡眠呼吸暂停综合征、重度慢性阻塞性肺疾病、肿瘤、重度感染病史或妊娠的参与者。记录参与者的病史并进行实验室检查。采用二元逻辑回归分析确定HF患者血清CA125水平与OSAS之间的关系。
HF+OSAS组血清CA125水平高于HF组（29.60±9.68 U/mL，P<0.001）。单因素分析显示，CA125（>35 U/mL）与胸腔积液、急性HF、呼吸暂停低通气指数（AHI）、左心室射血分数（LVEF）和N末端B型利钠肽原（NT-proBNP）水平显著相关。最后，AHI在多项分析中显示出统计学意义（OR 1.070，95%CI：1.019-1.124，P=0.006）。Spearman等级相关系数分析显示，CA125与AHI呈正相关，且Ln（CA125）（Ln是以e为底的自然对数）随AHI升高而逐渐升高（r=0.551，P<0.0001）。
合并OSAS的HF患者CA125水平进一步升高，且CA125（>35 U/mL）与AHI呈正相关。作为一种与炎症和充血相关的生物标志物，血清CA125在HF合并OSAS患者的诊断中可能具有一定价值。
