A urine biomarker for severe obstructive sleep apnoea patients: lipocalin-type prostaglandin D synthase
A urine biomarker for severe obstructive sleep apnoea patients: lipocalin-type prostaglandin D synthase
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DOI：
10.1183/09031936.00133512
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发表时间：
2013-12-01
影响因子：
24.3
通讯作者：
Urade, Yoshihiro
中科院分区：
文献类型：
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作者：
Chihara, Yuichi;Chin, Kazuo;Urade, Yoshihiro
脂质运载蛋白型前列腺素D合成酶（Lipocalin-type prostaglandin D synthase，L-PGDS）负责前列腺素D-2的生物合成，与心血管疾病和睡眠调节密切相关。本研究的目的是检验假设，L-PGDS水平是一个有用的标志物，以确定阻塞性睡眠呼吸暂停患者。64例受试者参加了这项前瞻性研究。在早晨测量L-PGDS的尿浓度。64例患者中有25例每4小时进行一次测量。通过反应性充血外周动脉张力指数评估内皮功能，L-PGDS浓度的昼夜变化具有显著的时间依赖性波动（p=0.0002）。重度阻塞性睡眠呼吸暂停受试者的L-PGDS（中位数为784.7 ng/mg肌酐，n=23）高于对照受试者（262.1 ng/mg肌酐，n=16; p=0.004）和中度阻塞性睡眠呼吸暂停受试者（371.7 ng/mg肌酐，n=25; p=0.0008）。持续气道正压通气治疗2天后，重度阻塞性睡眠呼吸暂停患者（n=12）的L-PGDS浓度显著降低（p=0.02）至对照组水平，而内皮功能无显著变化。晨尿L-PGDS浓度与呼吸暂停/低通气指数（R-2=13.9%）和血清高密度脂蛋白胆固醇（R-2=6.2%）显著相关，但与嗜睡程度无关，可作为重度阻塞性睡眠呼吸暂停患者的一个中度有用的指标。
Lipocalin-type prostaglandin D synthase (L-PGDS), which is responsible for the biosynthesis of prostaglandin D-2, has been reported to have a close connection with cardiovascular disease and sleep regulation. This study aimed to test the hypothesis that the L-PGDS level is a useful marker to identify patients with obstructive sleep apnoea.64 subjects were enrolled in this prospective study. Urinary concentrations of L-PGDS were measured in the morning. Measurements were made every 4 h in 25 of the 64 patients. Endothelial function was assessed by the reactive hyperaemia peripheral arterial tone index.Circadian variations in L-PGDS concentrations had a significant time-dependent fluctuation (p=0.0002). L-PGDS was higher in the subjects with severe obstructive sleep apnoea (median 784.7 ng per mg of creatinine, n=23) than in control subjects (262.1 ng per mg of creatinine, n=16; p=0.004) and in those with moderate obstructive sleep apnoea (371.7 ng per mg of creatinine, n=25; p=0.0008). After 2 days of continuous positive airway pressure treatment, L-PGDS concentrations in severe obstructive sleep apnoea subjects (n=12) decreased significantly (p=0.02) to levels present in control subjects whereas endothelial function did not change significantly. Morning urinary L-PGDS concentrations had significant correlations with the apnoea/hypopnoea index (R-2=13.9%) and serum high-density lipoprotein cholesterol (R-2=6.2%), but not with sleepiness.Urinary L-PGDS might be a moderately useful marker to identify patients with severe obstructive sleep apnoea.