Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.
Ann Med. 2024 Dec;56(1):2361825. doi: 10.1080/07853890.2024.2361825. Epub 2024 Jul 8.
Intestinal barrier dysfunction and systemic inflammation are common in obstructive sleep apnoea (OSA). We aimed to investigate the role of melatonin, an anti-inflammatory mediator, in mediating the relationships between OSA, intestinal barrier dysfunction and systemic inflammation.
Two hundred and thirty-five male participants who complained with sleep problems and underwent whole night polysomnography at our sleep centre between 2017 and 2018 were enrolled. Polysomnographic data, anthropometric measurements and biochemical indicators were collected. Serum melatonin, intestinal barrier function biomarker zonula occludens-1 (ZO-1) and inflammatory biomarkers C-reactive protein (CRP) with lipopolysaccharide (LPS) were detected. Spearman's correlation analysis assessed the correlations between sleep parameters, melatonin and biomarkers (ZO-1, LPS and CRP). Mediation analysis explored the effect of OSA on intestinal barrier dysfunction and systemic inflammation in moderate-severe OSA patients.
As OSA severity increased, serum melatonin decreased, whereas ZO-1, LPS and CRP increased. Spearman's correlation analysis showed that serum melatonin was significantly negatively correlated with ZO-1 ( = -0.19, < .05) and LPS ( = -0.20, < .05) in the moderate-OSA group; serum melatonin was significantly negatively correlated with ZO-1 ( = -0.46, < .01), LPS ( = -0.35, < .01) and CPR ( = -0.30, < .05) in the severe-OSA group. Mediation analyses showed melatonin explain 36.12% and 35.38% of the effect of apnoea-hypopnea index (AHI) on ZO-1 and LPS in moderate to severe OSA patients.
Our study revealed that melatonin may be involved in mediating intestinal barrier dysfunction and systemic inflammation in moderate-to-severe OSA patients.
肠道屏障功能障碍和全身炎症在阻塞性睡眠呼吸暂停（OSA）中很常见。我们旨在研究褪黑素作为一种抗炎介质，在介导 OSA、肠道屏障功能障碍和全身炎症之间关系中的作用。
2017 年至 2018 年期间，我们睡眠中心有 235 名男性抱怨睡眠问题并接受了整夜多导睡眠图检查。收集了多导睡眠图数据、人体测量学测量值和生化指标。检测了血清褪黑素、肠道屏障功能生物标志物紧密连接蛋白-1（ZO-1）和炎症生物标志物 C 反应蛋白（CRP）与脂多糖（LPS）。Spearman 相关性分析评估了睡眠参数、褪黑素与生物标志物（ZO-1、LPS 和 CRP）之间的相关性。中介分析探讨了 OSA 对中重度 OSA 患者肠道屏障功能障碍和全身炎症的影响。
随着 OSA 严重程度的增加，血清褪黑素降低，而 ZO-1、LPS 和 CRP 增加。Spearman 相关性分析显示，在中度 OSA 组中，血清褪黑素与 ZO-1（r=-0.19，P<0.05）和 LPS（r=-0.20，P<0.05）呈显著负相关；在重度 OSA 组中，血清褪黑素与 ZO-1（r=-0.46，P<0.01）、LPS（r=-0.35，P<0.01）和 CRP（r=-0.30，P<0.05）呈显著负相关。中介分析表明，褪黑素解释了 AHI 对中重度 OSA 患者 ZO-1 和 LPS 影响的 36.12%和 35.38%。
我们的研究表明，褪黑素可能参与了中重度 OSA 患者肠道屏障功能障碍和全身炎症的发生。
