Objective To investigate the prevalence of obstructive sleep apnea hypopnea syndrome ( OSAHS) in patients with idiopathic pulmonary fibrosis ( IPF) and its clinical significance. Methods Sleep quality and breathing disorders were measured by polysomnography and the relationship with lung function was analyzed in 20 IPF patients. Results Thirteen of 20 subjects ( 65% ) had OSAHS as defined by an AHI ≥5 events per hour. Three subjects ( 15% ) had mild OSAHS ( AHI,5 to 20 events per hour) , and 10 subjects ( 50% ) had moderate-to-severe OSAHS ( AHI≥20 events per hour) . The sleep architecture in these patients showed a reduction in sleep efficiency, rapid eye movement ( REM) sleep and slow wave sleep, and a marked sleep fragmentation due to an increased arousal index. The AHI was negatively correlated with FVC% pred ( r =-0.672, P=0.001) and FEV1% pred ( r =-0.659, P=0.002) , and positively correlated with body mass index ( BMI) ( r=0.791, Plt;0.0001) . Conclusions OSAHS is a common comorbidity in IPF. Early treatment of OSAHS may improve quality of life and the prognosis of patients with IPF.
ObjectiveTo systematically review the association between the level of plasma YKL-40 and obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsWe searched PubMed, EMbase, MEDLINE, CNKI, WanFang Data, VIP database and supplemented by Google academic retrieval to collect case-control studies about the association between the level of plasma YKL-40 and OSAHS from inception to April 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. And then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 case-control studies were included, involving 755 OSAHS patients and control population. The results of meta-analysis showed that the level of plasma YKL-40 in OSAHS patients was higher than that in control group (SMD=1.20, 95%CI 0.33 to 2.06, P=0.007). The subgroup analysis showed that the level of plasma YKL-40 in OSAHS patients from Asia was significantly higher than that in control group (SMD=1.79, 95%CI 0.83 to 2.75, P=0.000 2). The comparison between different severity of OSAHS showed that the wild-medium group had lower plasma level of YKL-40 than the severe group (SMD=–0.83, 95%CI –1.46 to –0.19, P=0.01).ConclusionYKL-40 may play an important role in the pathogenesis of OSAHS. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusions.
Objective To explore the difference between the hemorheology levels and the expression of hypoxia inducible factor 1α/2α (HIF-1α/2α) in the peripheral blood mononuclear cells of the Tibetan and Han patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods This research recruited 30 high-risk Tibetan and Han patients with OSAHS, and 30 Tibetan and Han healthy volunteers at the same period. The whole blood viscometer was used to detect the high shear rate of whole blood viscosity, low shear rate of whole blood viscosity, plasma viscosity ratio, red blood cell aggregation index, and hematocrit in each group. RT-qPCR and Western blot assays were used to detect the mRNA and protein levels of phosphoinositide 3-kinase (PI3K), serine/threonine kinase (AKT), nuclear factor-κB (NF-κB) p65, HIF-1α and HIF-2α in peripheral blood mononuclear cells. Results The hemorheology level of Tibetan OSAHS patients was significantly higher than that of healthy Tibetans and Han OSAHS patients (P<0.05), and the hemorheology level of Han OSAHS patients was significantly higher than that of Han healthy people (P<0.05) . The mRNA and protein levels of PI3K, AKT, NF-κB p65 and HIF-1α in the peripheral blood mononuclear cells of Tibetan OSAHS patients were significantly higher than those of the healthy Tibetans or Han people, and these indexes of the Han OSAHS patients were significantly higher than those of the Han healthy people (all P<0.05), while HIF-2α mRNA and protein levels were significantly lower than those of healthy Han people (all P<0.05). Conclusion The upregulation of HIF-1α level and downregulation of HIF-2α expression in peripheral blood mononuclear cells of OSAHS patients depend on the activation of the PI3K/AKT/NF-κB p65 signaling pathway, and the hemorheological level of Tibetan OSAHS patients is higher than that of Han OSAHS patients.
ObjectiveTo investigate the effects and clinical significance of edaravone on serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and intercellular adhesion molecule-1 (ICAM-1) in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsA total of 90 elderly patients with moderate to severe OSAHS confirmed by polysomnography were recruited from North China University of Science and Technology Affiliated Hospital in February 2016 to October 2017. According to random number table method the OSAHS patients were randomly divided into group A (n=30), group B (n=30) and group C (n=30). Group A received continuous positive airway pressure treatment for six months, group B received edaravone therapy and continuous positive airway pressure treatment for six months, and group C only received edaravone therapy for six months. The changes of serum TNF-α, IL-6 and ICAM-1 were detected by enzyme-linked immunosorbent assay before and after treatment.ResultsThe differences of serum TNF-α, IL-6 and ICAM-1 before treatment in the three groups were not statistically significant (P>0.05). Compared with before treatment, the levels of serum TNF-α, IL-6 and ICAM-1 decreased in the three groups (P<0.05). After six months of treatment, the levels of serum TNF-α, IL-6 and ICAM-1 decreased in group A and group B compared with group C (P<0.05), and decreased significantly in group B compared with group A (P<0.05).ConclusionEdaravone can inhibit the expressions of serum TNF-α, IL-6 and ICAM-1 in elderly patients with moderate to severe OSAHS, and thereby reduce vascular endothelial dysfunction and injury.
Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.
Objective
To investigate the relatingship between leptin receptor gene Gln223Arg polymorphism and obstructive sleep apnea hyponea syndrome (OSAHS) in Han population in Southwest China.
Methods
Two hundred and fifteen cases of subjects (including 116 cases in OSAHS group and 99 cases in control group) were selected in Han population in Southwest China. Polymerase chain reaction (PCR) was used to analyse Gln223Arg leptin receptor gene polymorphism. The levels of serum LEP and TI were determined by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Simultaneous determination of body mass index (BMI) and neck circumference (NC) and waist circumference (WC) were conducted.
Results
In the OSAHS group, the leptin receptor gene polymorphism Gln223Arg GG, AA and GA genotype frequency was 0.854, 0.017 and 0.129, respectively. G allele and A allele frequency frequency was 0.918 and 0.082, respectively. In the control group, leptin receptor gene polymorphisms Gln223Arg GG, AA and GA genotype frequency was 0.840, 0.020 and 0.14,respectively. G allele and A allele frequency was 0.90 and 0.10, respectively. Genotype frequencies of the two groups were not statistically significant (χ2=0.784, P>0.05). There were differences in BMI, WC and NC between the OSAHS patients with GG and the OSAHS patients with (GA+AA) genotype (P<0.05), but no difference was found in LEP and TI levels (allP>0.05). In control, mild, moderate and severe OSAHS group, the levels of serum LEP and TI were increased gradually, and the difference was statistically significant (allP<0.05).
Conclusions
Gln223Arg leptin receptor genotype polymorphisms may be involved in obesity, but they have no relationship with the incidence of OSAHS in Han population in Southwest China. In OSAHS patients, Gln223Arg polymorphism has no relationship with LEP or TI. Patients with OSAHS have hyperleptinemia and hyperinsulinemia.
Objective
To explore the mechanism of chronic intermittent hypoxia (CIH) on renal damage with normal diet and high-fat diet.
Methods
Twenty-four healthy male Wistar rats of SPF grade were randomly divided into 4 groups (n=6 in each group), namely group A (normoxia and common diet), group B (normoxia and high fat diet), Group C (CIH and common diet), and group D (CIH and high fat diet). The serum cystatin C (Cys-C) was measured and the renal CHOP protein was detected by immunohistochemistry. The ultrastructural changes of glomeruli and renal tubules were observed under electron microscope.
Results
The levels of Cys-C in group B, group C and group D were significantly higher than those in group A (P<0.05). The mean density of endoplasmic reticulum stress (ERS) marker protein CHOP in group B, group C and group D was significantly higher than that in group A (P<0.05). Electron microscope revealed focal nuclear pyknosis in the partly renal tubular epithelial cells, sparse and scattered brush border in group B and group C, also revealed nuclear pyknosis in a large number of tubular epithelial cells, sparse and scattered brush border in group D.
Conclusion
CIH can activate the ERS mediated renal tubular epithelial apoptosis, thus induce ultrastructure changes and damage of kidney.
【Abstract】 Objective To study the effects of obstructive sleep apnea hypopnea syndrome ( OSAHS) on blood pressure variations, and explore the possible mechanism. Methods 84 adult patients ( mean age 50. 1 ±14. 8 years, male /female 67 /17) were recruited for polysomnography ( PSG) and ambulatory blood pressure monitoring. Four groups were identified based on apnea hyponea index ( AHI) ,ie. non-OSAHS group ( n=9) ,mild group ( n=19) , moderate group ( n=23) , and severe group ( n =33) .The blood pressure levels were compared among the four groups. Correlations between PSG indexes,variations of systolic blood pressure ( SBP) and diastolic blood pressure ( DBP) were analyzed. Results Inter-group blood pressure comparison showed significant differences in SBP and DBP( P lt;0. 05) , except forthe mild and the moderate OSAHS patients. As compared with the non-OSAHS patients, SBP for those with severe OSAHS was about 15 mm Hg higher, and DBP 10 mm Hg higher. Observation on SBP non-dipping rate indicated that, except for the mild and the moderate OSAHS patients where no significant differences were found, SBP non-dipping rate increased with the severity of OSAHS( the rates were 78. 3%, 57. 1% ,54. 5%, and 32. 6% , respectively for the four groups) , whereas DBP non-dipping rate significantly increased in the severe OSAHS patients( 54. 3% ) ( P lt;0. 05) . For the mild OSAHS patients, blood pressure was found to be correlated positively with the body mass index ( correlation coefficient for day time SBP was 0. 26, and for DBP was 0. 22) , the arousal index ( correlation coefficient for day time SBP was 0. 25, and for DBP was 0. 17) , and heart rate variation ( correlation coefficient for night time SBP was 0. 18, and for DBP was 0. 17) . For the moderate OSAHS patients, a positive correlation was also found between blood pressure and AHI ( correlation coefficient for day time SBP was 0. 31, and for DBP was 0. 22, correlation coefficient fornight time SBP was 0. 26) , and between blood pressure and the longest hypopnea time during sleep ( LH) ( correlation coefficient for night time DBP was 0. 2) . For the severe OSAHS patients, blood pressure was correlated positively with apnea index ( AI) ( correlation coefficient for day time SBP was 0. 61, and for DBP was 0. 5, correlation coefficient for night time SBP was 0. 57 and for night time DBP was 0. 48) . Conclusions OSAHS has ber impact on SBP than on DBP. DBP hypertension and SBP non-dipping are usually found in early OSAHS-affected patients. Factors affecting blood pressure differ with the severity of the OSAHS.
Obstructive sleep apnea hypopnea syndrome (OSAHS) can affect the growth and development of minors. Although the gold standard for OSAHS diagnosis is an overnight polysomnography, its clinical application is limited due to the high requirements for equipment and environmental conditions. Body shape indicators can reflect the accumulation of fat in specific parts of the body. In recent years, body shape indicators (body mass index, neck circumference, waist circumference, waist to hip ratio, waist to height ratio, neck circumference to height ratio) have been increasingly used in the evaluation of minor OSAHS. This article will review the application of the above body shape indicators in the evaluation of minor OSAHS, aiming to provide a basis for better use of these indicators in the diagnosis and treatment of minor OSAHS.
Objective To study the differences of obstructive sleep apnea hypopnea syndrome (OSAHS)-related indexes between Uyghur and Han, and to provide evidence for the development of individualized treatment measures for different ethnic groups. Methods 224 Han OSAHS patients were collected from Guangdong Provincial Hospital of Chinese Medicine, and 178 Uygur OSAHS patients were collected from The First People’s Hospital of Kashi between January 2018 and December 2019. The collected data information included age, sex, nationality, body mass index (BMI), apnea hypopnea index (AHI), lowest oxygen saturation (LSaO2), OSAHS stage, mean corpuscular hemoglobin concentration (MCHC), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), fasting blood glucose (FBG), and glycosylated hemoglobin (HbAlc). After using propensity matching scores to reduce confounding factors, differences in above indicators between different nationalities were compared. Results The mean values of MCHC, TC and HDL in Uygur OSAHS patients were lower than those in Han patients at the same stage, and the mean values of LSaO2 and LDL in mild and severe Uygur OSAHS patients were lower than those in Han patients at the same stage, with statistically significant differences (all P<0.05). There were no significant differences in AHI, TG, FBG or HbAlc between Uygur and Han patients with OSAHS. Conclusion There are significant differences in LSaO2, LDL, MCHC, TC and HDL between Uygur and Han Chinese patients with OSAHS.
