Objective: To investigate the levels of plasma adipokines angiopoietin-like 4(ANGPTL-4), complement-C1q/tumor necrosis factor-related protein 3(CTRP-3), dipeptidyl peptidase 4(DDP4) and fibroblast growth factors 21(FGF-21) levels and their relationships with the severity of obstructive sleep apnea(OSA), and explore the pathogenesis of OSA. Methods: Adult patients in Chest District of Nanjing Brain Hospital and Kunshan First People's Hospital were enrolled from January 2017 by order of visits. After polysomnographic monitoring(PSG), all the patients was divided into simple snoring group, mild OSA, moderate OSA, severe OSA group(n=50,respectively) according to apnea-hypopnea index(AHI). Plasma ANGPTL-4, CTRP-3, DDP-4 and FGF-21 levels were compared and analyzed the correlation with the severity of OSA. Results: Plasma ANGPTL-4, DPP4 and FGF-21 levels in OSA groups were increased compared with the simple snoring group while CTRP-3 decreased(P<0.05). Whether before sleep or after awakening, plasma ANGPTL-4, DDP4 and FGF-21 levels in OSA patients were positively associated with body mass index(BMI), neck circumference and AHI, but negatively with lowest pulse oxygen saturation(SpO2) and mean SpO2(P<0.05),while The results of CTRP-3 were just the opposite. Whether before or after PSG, the levels of plasma ANGPTL-4, CTRP-3, DPP4 and FGF-21 in each group showed no statistical difference(P>0.05). Conclusion: The levels of adipokines CTRP-3 decreased with the aggravation of OSA, while ANGPTL-4, DPP4 and FGF-21 showed the opposite results, but no rhythm changes in these four adipokines before sleep or after awakening. |
[1] WEI Z,CHEN Y,UPENDER R P.Sleep disturbance and metabolic dysfunction:the roles of adipokines[J].Int J Mol Sci,2022,23(3):1706.
[2] XU T,LIN Y,SUN S,ZHANG Q.Changes in four plasma adipokines before and after sleep in OSAS patients[J].Clin Respir J,2017,11(6):968-974.
[3] 成人阻塞性睡眠呼吸暂停基层诊疗指南(2018年)[J].中华全科医师杂志,2019,(1):21-29.
[4] FUNCKE J B,SCHERER P E.Beyond adiponectin and leptin:adipose tissue-derived mediators of inter-organ communication[J].J Lipid Res,2019,60(10):1648-1684.
[5] LEHR S,HARTWIG S,SELL H.Adipokines:a treasure trove for the discovery of biomarkers for metabolic disorders[J].Proteomics Clin Appl,2012,6(1-2):91-101.
[6] AKILLI H,KAYRAK M,BEKCI T T,et al.Gender-related changes of the epicardial fat thickness and leptin in obstructive sleep apnea[J].Echocardiography,2014,31(4):411-419.
[7] 杨帆,李康,杨颖,等.生物电阻抗法测量的内脏脂肪面积与性别年龄及代谢性因素的相关性分析[J].中国介入心脏病学杂志,2016,24(3):134-141.
[8] CANAPARI C A,HOPPIN A G,KINANE T B,et al.Relationship between sleep apnea,fat distribution,and insulin resistance in obese children[J].J Clin Sleep Med,2011,7(3):268-273.
[9] SANTULLI G.Angiopoietin-like proteins:a comprehensive look[J].Front Endocrinol,2014,5:4.
[10] BARJA-FERNANDEZ S,MORENO-NAVARRETE J M,FOLGUEIRA C,et al.Plasma ANGPTL-4 is associated with obesity and glucose tolerance:cross-sectional and longitudinal findings[J].Mol Nutr Food Res,2018,62(10):e1800060.
[11] HATA S,NOMURA T,IWASAKI K,et al.Hypoxia-induced angiopoietin-like protein 4 as a clinical biomarker and treatment target for human prostate cancer[J].Oncol Rep,2017,38(1):120-128.
[12] AL-TERKI A,ABU-FARHA M,ALKHAIRI I,et al.Increased level of angiopoietin like proteins 4 and 8 in people with sleep apnea[J].Front Endocrinol,2018,9:651.
[13] CINKAJZLOVA A,MRAZ M,LACINOVA Z,et al.Angiopoietin-like protein 3 and 4 in obesity,type 2 diabetes mellitus,and malnutrition:The effect of weight reduction and realimentation [J].Nutr.Diabetes,2018,8(1):21.
[14] BARJA-FERNANDEZ S,FOLGUEIRA C,CASTELAO C,et al.ANGPTL-4 is associated with obesity and lipid profile in children and adolescents[J],Nutrients,2019,11(6):1340.
[15] ZHANG J,ZHANG B,CHENG Y,et al.Low plasma CTRP3 levels are associated with nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus[J].Cytokine,2018,106:131-135.
[16] ZENG X,PENG Y,WANG Y,et al.C1q/tumor necrosis factor-related protein-3(CTRP3) activated by forkhead box O4(FOXO4) down-regulation protects retinal pericytes against high glucose-induced oxidative damage through nuclear factor erythroid 2-related factor 2(Nrf2)/Nuclear factor-kappaB(NF-κB) signaling[J].Bioengineered,2022,13(3):6080-6091.
[17] SONG Y,ZHANG Y,WAN Z,et al.CTRP3 alleviates myocardial ischemia/reperfusion injury in mice through activating LAMP1/JIP2/JNK pathway[J].Int Immunopharmacol,2022,107:108681.
[18] KOLDEMIR G M.BGM,a newly synthesised boron compound,induces apoptosis and reduces oxidative stress by inhibiting lipogenesis in 3T3-L1 adipocytes via PPARγ and CTRP3[J].Biol Trace Elem Res,2022,200(11):4807-4816.
[19] 屠晓芳,钮忆欣,秦利,等.血清二肽基肽酶4酶活性与脂代谢异常相关性研究[J].中华内分泌代谢杂志,2020,(5):387-392.
[20] 王川,严励.二肽基肽酶4抑制剂沙格列汀控制餐后血糖的关键:促进餐后胰岛素分泌[J].中国糖尿病杂志,2022,30(2):147-150.
[21] FANGMANN D,GEISLER C,SCHLICHT K,et al.Differential effects of protein intake versus intake of a defined oligopeptide on FGF-21 in obese human subjects in vivo[J].Clin Nutr,2021,40(2):600-607.
[22] 李刚,籍胤玺,冯延,等.β-arrestin2、RBP4及FGF-21在2型糖尿病足中的表达及与糖脂代谢的关系研究[J].分子诊断与治疗杂志,2020,12(10):1328-1331.
[23] WANG H W,JIANG X,ZHANG Y,et al.FGF-21 protects against hypoxia injury through inducing HSP72 in cerebral microvascular endothelial cells[J].Front Pharmacol,2019,10:101.
[24] YAO D,HE Q,SUN J,et al.FGF-21 attenuates hypoxia-induced dysfunction and inflammation in HPAECs via the microRNA-27b-mediated PPARγ pathway[J].Int J Mol Med,2021,47(6):116.
[25] KHALAFI M,ALAMDARI K A,SYMONDS M E,et al.Impact of acute exercise on immediate and following early post-exercise FGF-21 concentration in adults:systematic review and meta-analysis[J].Hormones,2021,20(1):23-33. |