Zhu Jing, Zeng Zhaofu, Xiong Mengqing, Mo Huaheng, Jin Meng, Hu Ke
Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060 Hubei China.
Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei China.
Sleep Biol Rhythms. 2022 Apr 28;20(3):421-429. doi: 10.1007/s41105-022-00387-4. eCollection 2022 Jul.
The relationship between plasma orexin A (OXA) levels and cognitive function in patients with obstructive sleep apnea (OSA) remains unclear. This study aimed to evaluate associations between daytime and nighttime plasma OXA levels and cognitive function in patients with OSA. Subjects with suspected OSA underwent overnight polysomnography (PSG), Montreal Cognitive Assessment (MoCA), and Epworth Sleepiness Scale (ESS) assessment. Subjects were considered controls or having OSA according to the apnea-hypopnea index (AHI). Daytime and nighttime plasma OXA levels were determined by ELISA. Receiver-operating characteristics curves were used to evaluate the diagnostic value of plasma OXA levels for assessing cognitive impairment in OSA patients. One hundred and six subjects met the inclusion criteria. MoCA scores and plasma OXA concentrations were significantly lower in OSA patients than controls ( < 0.01). Patients with moderate and severe OSA had significantly lower MoCA scores than controls and mild OSA patients ( < 0.01). Daytime and nighttime OXA levels were significantly lower in OSA patients with cognitive impairment than those without cognitive impairment ( < 0.01). Both daytime and nighttime plasma OXA levels in patients with OSA were positively correlated with MoCA scores and nadir SaO, negatively correlated with AHI, oxygen desaturation index, and percentage of time spent with an SaO below 90% (all < 0.05), and not correlated with ESS scores. The optimal threshold of daytime plasma OXA to diagnose OSA with cognitive impairment was 49.34 pg/ml, with a sensitivity of 80.0% and a specificity of 74.3%. We concluded that plasma OXA concentrations might be related to cognitive function and daytime plasma OXA levels have diagnostic value for assessing cognitive impairment in OSA patients.
The online version contains supplementary material available at 10.1007/s41105-022-00387-4.
阻塞性睡眠呼吸暂停（OSA）患者血浆食欲素A（OXA）水平与认知功能之间的关系尚不清楚。本研究旨在评估OSA患者白天和夜间血浆OXA水平与认知功能之间的关联。疑似OSA的受试者接受了整夜多导睡眠图（PSG）、蒙特利尔认知评估（MoCA）和爱泼华嗜睡量表（ESS）评估。根据呼吸暂停低通气指数（AHI）将受试者分为对照组或患有OSA。采用酶联免疫吸附测定法（ELISA）测定白天和夜间血浆OXA水平。采用受试者工作特征曲线评估血浆OXA水平对评估OSA患者认知障碍的诊断价值。106名受试者符合纳入标准。OSA患者的MoCA评分和血浆OXA浓度显著低于对照组（<0.01）。中度和重度OSA患者的MoCA评分显著低于对照组和轻度OSA患者（<0.01）。有认知障碍的OSA患者白天和夜间OXA水平显著低于无认知障碍的患者（<0.01）。OSA患者白天和夜间血浆OXA水平均与MoCA评分和最低血氧饱和度呈正相关，与AHI、氧饱和度下降指数以及血氧饱和度低于90%的时间百分比呈负相关（均<0.05），与ESS评分无关。诊断伴有认知障碍的OSA的白天血浆OXA最佳阈值为49.34 pg/ml，敏感性为80.0%，特异性为74.3%。我们得出结论，血浆OXA浓度可能与认知功能有关，白天血浆OXA水平对评估OSA患者的认知障碍具有诊断价值。
在线版本包含可在10.1007/s41105-022-00387-4获取的补充材料。
