血管生成素样蛋白3对阻塞性睡眠呼吸暂停患者脂质代谢的影响  

Correlation study of angiopoietin-like protein 3 with lipid metabolism in obstructive sleep apnea patients

作　　者：秦兵俊 李雨凝 宋诗文 蒋军广[1] QIN Bingjun;LI Yuning;SONG Shiwen;JIANG Junguang(Elderly Respiratory Sleep Department,The First Affiliated Hospital of Zhengzhou University,Henan Institute of Respiratory Disease,Zhengzhou,Henan 450052,P.R.China)

机构地区：[1]郑州大学第一附属医院河南省呼吸疾病研究所老年呼吸睡眠科,河南郑州450052

出　　处：《中国呼吸与危重监护杂志》2025年第3期167-171,共5页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：国家卫生和计划生育委员会临床重点专科建设项目(国卫办医函[2013]544号)。

摘　　要：目的探讨血管生成素样蛋白3(angiopoietin-like protein 3,ANGPTL3)对阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)患者脂质代谢的影响。方法将2023年5月—2024年2月期间就诊于郑州大学第一附属医院的59例OSA患者及同期20例健康体检者纳入研究。所有研究对象均接受整夜多导睡眠监测(polysomnography,PSG)。根据呼吸暂停低通气指数(apnea hypopnea index,AHI)将OSA患者分为轻度组及中重度组。在空腹8 h后采集所有研究对象的晨起血液样本,检测血脂指标及ANGPTL3水平,应用SPSS 25.0软件进行统计学分析。结果OSA组总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、ANGPTL3水平均高于对照组,高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)水平低于对照组(P<0.05)。中重度OSA组ANGPTL3水平高于轻度OSA组及对照组,轻度OSA组ANGPTL3水平高于对照组(P<0.05)。重度低氧血症组ANGPTL3水平明显高于轻-中度低氧血症组(P<0.05)。血脂升高组ANGPTL3水平明显高于非血脂升高组(P<0.05)。OSA组中ANGPTL3与TC、TG、动脉血氧饱和度小于90%的时长在总睡眠时长中的占比、氧减指数呈正相关,与最低血氧饱和度、平均血氧饱和度呈负相关。以是否发生OSA为结局变量,调整相关混杂因素后,结果提示ANGPTL3可能是OSA的独立危险因素,OR(95%CI)为1.021(1.002~1.040)。结论OSA患者的ANGPTL3水平升高。OSA患者血脂升高可能与慢性间歇性缺氧调节ANGPTL3水平升高有关。Objective To investigate the effect of angiopoietin-like protein 3(ANGPTL3)on lipid metabolism in patients with obstructive sleep apnea(OSA).Methods A total of 59 OSA patients and 20 healthy controls from the First Affiliated Hospital of Zhengzhou University between May 2023 and February 2024 were included in the study.All participants underwent overnight polysomnography(PSG).Based on the apnea-hypopnea index(AHI),the OSA patients were divided into a mild group and a moderate-to-severe group.Morning blood samples were collected after an 8-hour fast to measure lipid profiles and ANGPTL3 levels.Statistical analyses were performed using SPSS 25.0 software.Results The levels of total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and ANGPTL3 were significantly higher,while high-density lipoprotein cholesterol(HDL-C)was significantly lower in the OSA group compared with the control group(P<0.05).ANGPTL3 level was higher in the moderate-to-severe OSA group than that in the mild OSA group and the control group,and higher in the mild OSA group than that in the control group(P<0.05).In the severe hypoxemia group,ANGPTL3 level was significantly higher than that in the mild-to-moderate hypoxemia group(P<0.05).The ANGPTL3 level was also significantly higher in the hyperlipidemia group compared wiht the non-hyperlipidemia group(P<0.05).In the OSA group,ANGPTL3 was positively correlated with TC,TG,percentage of cumulative time with oxygen saturation below 90%in total sleep time(T90)and oxygen desaturation index(ODI),and negatively correlated with lowest arterial oxygen saturation(LSaO_2)and mean arterial oxygen saturation(MSaO_2).After adjusting for relevant confounding factors,logistic regression analysis indicated that ANGPTL3 might be a potential independent risk factor for OSA,with an odds ratio of 1.021(95%CI 1.002-1.040).Conclusions The level of ANGPTL3is elevated in OSA patients.The elevation of blood lipid levels in OSA patients may be associated with chronic intermittent hypoxia-induced r

关 键 词：阻塞性睡眠呼吸暂停 血管生成素样蛋白3 脂质代谢 慢性间歇性缺氧 

分 类 号：R76[医药卫生—耳鼻咽喉科]