The Impact of Obstructive Sleep Apnea and Nasal CPAP on Circulating Adiponectin Levels
The Impact of Obstructive Sleep Apnea and Nasal CPAP on Circulating Adiponectin Levels
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DOI：
10.1007/s00408-013-9550-9
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发表时间：
2014-01
期刊：
影响因子：
5
通讯作者：
M. Yoshikawa;M. Yamauchi;Y. Fujita;Norikoko Koyama;A. Fukuoka;S. Tamaki;Yoshifumi Yamamoto;K. Tomoda;H. Kimura
中科院分区：
文献类型：
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作者：
M. Yoshikawa;M. Yamauchi;Y. Fujita;Norikoko Koyama;A. Fukuoka;S. Tamaki;Yoshifumi Yamamoto;K. Tomoda;H. Kimura
目的阻塞性睡眠呼吸暂停综合征（OSAS）是心血管疾病的重要危险因素，但其发病机制尚未完全阐明。粘附分子介导的单核细胞跨内皮迁移是动脉粥样硬化发病机制中的关键步骤。我们研究了低氧应激对OSAS患者血浆脂联素和肿瘤坏死因子-α（TNF-α）水平的影响以及脂联素和TNF-α是否调节粘附分子。在多导睡眠描记术后和经鼻持续气道正压通气后清晨测定血浆脂联素和TNF-α水平以及血清可溶性细胞间粘附分子-1（sICAM-1）浓度。结果血浆脂联素水平与呼吸暂停低通气指数（AHI）（r=-0.582，p < 0.005）和SpO 2 <90%的时间百分比（r=-0.539，p < 0.01）呈负相关，但与体重指数（BMI）无关。TNF-α水平与AHI（r= 0.462，p < 0.05）和BMI（r= 0.452，p < 0.05）呈正相关。血清sICAM-1水平与血浆脂联素水平呈负相关（r= − 0.476，p < 0.05），但与TNF-α水平无相关性。10例患者经nCPAP过夜治疗后，血浆TNF-α水平下降（p< 0.05），而经nCPAP长期治疗（3个月）后，血浆脂联素水平升高（p< 0.02）。脂联素水平降低与sICAM-1水平相关。
PurposeAlthough obstructive sleep apnea syndrome (OSAS) is known to be an important risk factor for cardiovascular diseases, the mechanism behind this association has not been fully elucidated. Transendothelial migration of monocytes mediated by adhesion molecules is a crucial step in the pathogenesis of atherosclerosis. We investigated the effect of hypoxic stress on plasma adiponectin and tumor necrosis factor-α (TNF-α) levels and whether adiponectin and TNF-α modulate adhesion molecules in patients with OSAS.MethodsIn 22 patients, plasma adiponectin and TNF-α levels and serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1) were determined early in the morning after polysomnography and after nasal continuous positive airway pressure (nCPAP) treatment.ResultsPlasma adiponectin levels were inversely correlated with the apnea–hypopnea index (AHI) (r= −0.582,p< 0.005) and % time in SpO2<90 % (r= −0.539,p< 0.01) but not with the body mass index (BMI). TNF-α levels were positively correlated with the AHI (r= 0.462,p< 0.05) and BMI (r= 0.452,p< 0.05). Serum sICAM-1 levels were inversely correlated with plasma adiponectin levels (r= −0.476,p< 0.05) but not with TNF-α levels. Although plasma TNF-α levels decreased after overnight nCPAP treatment (p< 0.05), plasma adiponectin levels increased after long-term nCPAP (3 months) treatment (p< 0.02) in ten patients.ConclusionsOur findings suggest that reduced adiponectin and elevated TNF-α levels in plasma are associated with OSAS-induced hypoxic stress. Decreased adiponectin levels are associated with sICAM-1 levels.