2型糖尿病患者血清鸢尾素、摄食抑制因子-1、3-硝基酪氨酸水平与糖脂代谢和阻塞性睡眠呼吸暂停低通气综合征的关系研究

摘要 目的：探讨2型糖尿病（T2DM）患者血清鸢尾素（Irisin）、摄食抑制因子-1（Nesfatin-1）、3-硝基酪氨酸（3-NT）水平与糖脂代谢和阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的关系。方法：选择2020年4月~2021年9月期间中国人民解放军总医院京南医疗区收治的T2DM患者80例作为研究对象,根据多导睡眠图（PSG）检查结果,合并OSAHS的51例患者列为T2DM合并OSAHS组,剩余的29例纳为T2DM未合并OSAHS组。选择同期来中国人民解放军总医院京南医疗区体检的40例健康志愿者作为对照组。对比T2DM患者、对照组的Irisin、Nesfatin-1、3-NT水平,采用Pearson相关性分析显示Irisin、Nesfatin-1、3-NT与糖脂代谢指标的相关性。T2DM患者发生OSAHS的影响因素采用多因素Logistic回归分析。结果：T2DM合并OSAHS组、T2DM未合并OSAHS组Irisin低于对照组,且T2DM合并OSAHS组低于T2DM未合并OSAHS组（P<0.05）。T2DM合并OSAHS组、T2DM未合并OSAHS组Nesfatin-1、3-NT高于对照组,且T2DM合并OSAHS组高于T2DM未合并OSAHS组（P<0.05）。T2DM合并OSAHS组、T2DM未合并OSAHS组糖化血红蛋白（HbAlc）、空腹血糖（FBG）、餐后2 h血糖（2hPG）高于对照组,且T2DM合并OSAHS组高于T2DM未合并OSAHS组（P<0.05）。T2DM合并OSAHS组、T2DM未合并OSAHS组三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）较对照组高,高密度脂蛋白胆固醇（HDL-C）低于对照组（P<0.05）。Pearson相关性分析结果显示,Irisin与HbAlc、FBG、2hPG呈负相关,Nesfatin-1、3-NT与HbAlc、FBG、2hPG呈正相关（P<0.05）。T2DM合并OSAHS组、T2DM未合并OSAHS组的年龄、合并高血压、体质量指数、AHI、空腹C肽、合并冠心病对比有差异（P<0.05）。Irisin、Nesfatin-1、3-NT、HbAlc、FBG、2hPG、年龄、合并高血压是T2DM患者发生OSAHS的影响因素（P<0.05）。结论：T2DM合并OSAHS患者的Irisin、Nesfatin-1、3-NT水平表达异常,参与着机体的糖脂代谢过程及OSAHS发生,且OSAHS发生同时还受到HbAlc、FBG、2hPG、年龄、合并高血压的影响,可考虑对上述因素进行早期监测,以进行相关干预。     

OSAHS患者腭咽组织中COX-2、VEGF的表达及其与新生血管生成的关系

目的：探讨阻塞性睡眠呼吸暂停低通气综合症（OSAHS）患者腭咽组织中环氧化酶-2（COX-2）、血管内皮生长因子（VEGF）的表达及其与新生血管生成的关系及意义。方法：经多导睡眠监测仪（PSG）确诊的40例OSAHS患者（其中轻度组7例,中度12例,重度21例）及6例无鼾症患者的软腭组织,采用HE染色光镜观察腭咽部组织的病理组织学改变,免疫组化技术检测COX-2,VEGF及微血管密度（MVD）的表达情况。结果：COX-2、VEGF主要表达于OSAHS患者软腭组织的黏膜鳞状上皮和导管腺上皮,中、重度OSAHS组与对照组比较,COX-2,VEGF,MVD表达均有显著差异（P〈0.01）,OSAHS组明显高于对照组,轻度组与对照组差别无统计学意义（P〉0.05）;COX-2、VEGF均与MVD的表达呈正相关（P〈0.01）,COX-2与VEGF的表达呈正相关（P〈0.01）,COX-2,VEGF,MVD均与睡眠呼吸暂停低通气指数（AHI）呈正相关（P〈0.01）,与夜间最低氧饱和度呈负相关（P〈0.01）。结论：OSAHS患者腭咽部存在新生血管增生,与缺氧程度有关,COX-2及VEGF在其发生发展过程中可能起到重要作用。     

学龄前阻塞性睡眠呼吸暂停低通气综合征儿童肠道菌群特征分析

摘要 目的：探讨学龄前阻塞性睡眠呼吸暂停低通气综合征（OSAHS）儿童与正常儿童肠道菌群的差异。方法：选取2023年7月至2023年11月期间新疆医科大学第一附属医院儿科门诊收治的学龄前OSAHS儿童30例作为OSAHS组,选取同期于新疆医科大学第一附属医院健康管理中心体检健康的儿童30例作为对照组。利用16SrDNA扩增子测序技术对肠道菌群进行分析。采用Spearman法分析睡眠质量与肠道菌群门、属水平丰度的相关性。结果：OSAHS组和对照组共发现2588个扩增子序列变异（ASVs）,OSAHS组检出特有ASVs 1034个,对照组检出特有ASVs 1554个。OSAHS组Chao1指数和Observed otus指数显著低于对照组（P<0.05）,两组间Shannnon指数、Simpson指数、Goods coverage指数、Peilou-e指数均差异无统计学意义（P>0.05）。OSAHS组与对照组间肠道菌群群落结构存在显著差异（P<0.05）。在门水平上,OSAHS组拟杆菌门的相对丰度低于对照组,厚壁菌门的相对丰度、厚壁菌门/拟杆菌门的比例高于对照组（P<0.05）。在属水平上,OSAHS组与对照组组优势菌群相对分度比较差异无统计学意义（P>0.05）。在门水平上,睡眠质量与拟杆菌门呈正相关（P<0.05）。在属水平上,睡眠质量与双歧杆菌属、乳杆菌属呈负相关,与拟杆菌属呈正相关（P<0.05）。阻塞性呼吸暂停低通气指数（OAHI）与肠杆菌属呈负相关（P<0.05）。最低血氧饱和度（LSaO₂）与肠杆菌属呈正相关（P<0.05）。平均血氧饱和度（MSaO₂）与X.Eubacterium._eligens_group呈正相关（P＜0.05）。结论：与正常儿童的肠道菌群的种类和相对丰度相比,学龄前OSAHS儿童的厚壁菌门/拟杆菌门比例升高,可能存在肠道菌群失调。睡眠质量在门、属水平上与拟杆菌门、双歧杆菌属、乳杆菌属明显相关。     

儿童阻塞性睡眠呼吸暂停低通气综合征与肥胖的相关性研究

目的:探讨儿童阻塞性睡眠呼吸暂停/低通气综合征(OSAHS)与肥胖的相关性。方法:收集单纯性肥胖儿童120例和体重正常儿童110例作为研究对象,进行统一的体格检查和专科检查,并进行多导睡眠监测记录阻塞性呼吸暂停指数(OAI)、呼吸暂停/低通气指数(AHI)、中枢性呼吸暂停指数(CAI)、最低血氧饱和度(LSa O2)和睡眠效率。结果:肥胖组OSAHS患病率为58.33%显著高于对照组的31.82%,差异有统计学意义(P0.05);OAI、AHI、CAI均显著高于对照组,而LSa O2、睡眠效率指标显著低于对照组,差异均有统计学意义(均P0.05);多因素回归分析显示,肥胖、扁桃体增生、腺样体增生是导致OSAHS的独立危险因素,差异有统计学意义(均P0.05)。结论:肥胖是儿童OSAHS发病的重要影响因素,特别是合并扁桃体肿大或腺样体肿大的患儿应注意预防OSAHS的发生。     

阻塞性睡眠呼吸暂停低通气综合征血压变异性及运动心肺功能与病情的相关性分析

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)血压变异性及运动心肺功能与病情的相关性分析。方法:选取2017年2月～2018年11月期间我院收治的OSAHS患者119例为研究对象,根据每小时睡眠呼吸暂停次数(AHI)将患者分为轻度组(AHI:5～20次/h,n=45)、中度组(AHI:21～40次/h,n=39)、重度组(AHI:40次/h,n=35),检测所有研究对象的血压变异性及运动心肺功能,并作组间比较。采用Pearson积矩相关分析OSAHS患者血压变异性及运动心肺功能与病情的相关性。结果:OSAHS患者收缩压(SBP)昼、舒张压(DBP)夜以及中度组、重度组SBP夜均高于对照组(P0.05);重度组DBP夜以及中度组、重度组SBP昼、SBP夜高于轻度组(P0.05);重度组SBP夜、SBP昼、DBP夜高于中度组(P0.05);而各组DBP昼整体比较差异无统计学意义(P0.05)。OSAHS患者最大摄氧量占预计值百分比(VO2max%pred)、最大摄氧量峰值占预计值百分比(peak VO2%pred)、无氧阈值(AT)、摄氧量功率比值(VO2/WR)、呼吸储备(VEmax/MVV)均低于对照组,且随病情严重程度的增加而降低(P0.05),OSAHS患者二氧化碳通气当量(VE/VCO2)高于对照组,且随病情严重程度的增加而升高(P0.05)。Pearson积矩相关分析结果显示,OSAHS患者病情严重程度与SBP昼、SBP夜、DBP夜、VE/VCO2呈正相关(P0.05),与VO2max%pred、peakVO2%pred、AT、VEmax/MVV、VO2/WR呈负相关(P0.05),与DBP昼无相关性(P0.05)。结论:血压变异性及运动心肺功能指标可反映OSAHS患者病情严重程度,可考虑作为早期监测指标并参考指导治疗。     

Screening obstructive sleep apnea–hypopnea syndrome from snorers in children by heart rate variability analysis

This study aimed to evaluate the application of time- and frequency-domain analysis of heart rate variability (HRV) to screen obstructive sleep apnea–hypopnea syndrome (OSAHS) from snorers in children. Snoring children who were more than 3 years old were recruited and simultaneously underwent standard polysomnography (PSG) and 24 h ambulatory electrocardiography. The HRV variables of the two groups were compared, and a threshold value of the most significant variables was determined to obtain better separation power between OSAHS and non-OSAHS conditions. PSG was made as a gold standard to evaluate the capacity of HRV analysis to screen OSAHS from snorers in children. PSG results showed that 58 children manifested OSAHS and 37 were non-OSAHS snorers. LF/HF_n ≥ 0.845 has the highest sensitivity of screening OSAHS from snorers with limited specificity, so the use of this ratio should not be overestimated.     

血脂、血小板参数、HOMA-IR与阻塞性睡眠呼吸暂停低通气综合征合并高血压患者PSG参数的相关性及其预测价值研究

摘要 目的：探讨血脂、血小板参数、稳态模型胰岛素抵抗指数（HOMA-IR）与阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并高血压患者多导睡眠图（PSG）参数的相关性及其预测价值。方法：选择2020年1月至2022年11月徐州医科大学附属沭阳医院收治的163例OSAHS患者，根据是否合并高血压将其分为单纯OSAHS组（78例）及高血压组（85例），检测两组血脂、血小板参数、HOMA-IR、PSG参数；Pearson相关性分析血脂、血小板参数、HOMA-IR与PSG参数的相关性；多因素Logistic回归分析OSAHS合并高血压的危险因素；受试者工作特征（ROC）曲线分析血脂、血小板参数、HOMA-IR预测OSAHS合并高血压的价值。结果：高血压组甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、平均血小板体积（MPV）、HOMA-IR、微觉醒指数（MAI）、呼吸暂停低通气指数（AHI）、氧减指数（ODI）高于单纯OSAHS组（P＜0.05），高密度脂蛋白胆固醇（HDL-C）水平低于单纯OSAHS组（P＜0.05）。高血压组TG、TC、LDL-C、MPV、HOMA-IR与MAI、AHI、ODI呈正相关（P＜0.05），HDL-C与MAI、AHI、ODI呈负相关（P＜0.05）。高体质量指数、高HOMA-IR及TG、MPV水平升高是OSAHS患者合并高血压的危险因素（P＜0.05）。联合TG、MVP、HOMA-IR预测OSAHS患者合并高血压的曲线下面积高于以上三指标单独预测。结论：OSAHS合并高血压患者TG、MPV水平及HOMA-IR显著增高，且与MAI、AHI、ODI呈正相关，TG、MPV、HOMA-IR联合检测对OSAHS患者合并高血压的预测价值较高。     

舌骨肌切开悬吊术结合腭咽成形术治疗重度OSAHS

目的：应用联合应用舌骨肌切开悬吊术和腭咽成形术治疗重度阻塞性睡眠呼吸暂停低通气综合征。方法：用多导睡眠监测确定52例重度阻塞性睡眠呼吸暂停低通气综合征,不同方法确定均为以舌根平面阻塞为主的上气道多平面狭窄。采用舌骨肌切开悬吊术联合腭咽成形术进行治疗。结果：所有接受手术的患者术后鼾声均有不同程度的减轻,手术总有效率94．2％。无1例出现不良并发症。结论：舌骨肌切开悬吊术安全、易行,结合腭咽成形术治疗重度阻塞性睡眠呼吸暂停低通气综合征效果良好。     

Interleukin-18 gene polymorphisms and rheumatoid arthritis: A meta-analysis

Interleukin-18 (IL-18) is a member of the IL-1 superfamily that enhances both innate and acquired immune responses. IL-18 is highly expressed in sera, synovial fluids and synovial tissues of patients with RA, and these IL-18 levels are correlated with RA disease activity, indicating an important role of IL-18 in the pathogenesis of RA. Several studies have examined the association of IL-18 gene polymorphisms with RA, but these studies have shown inconclusive and controversial results. To verify the association between IL-18 gene polymorphism and susceptibility to RA, we conducted a meta-analysis of all relevant reports cited in MEDLINE/PubMed before October 2012. A meta-analysis on the association between the IL-18 rs1946518 SNP and RA was performed for 2944 patients with RA and 2377 controls from 7 published studies and a meta-analysis on the association between the IL-18 rs187238 SNP and RA was performed for 1319 patients with RA and 1211 controls from 5 published studies. In addition, 2 studies involving 1873 RA patients and 1092 controls were considered in the meta-analysis of the association between the IL-18 rs360722 SNP and RA. No significant association was found between two IL-18 SNPs (rs1946518 and rs187238) and RA susceptibility in all subjects. In subgroup analysis stratified by ethnicity, there was still no significant association between these two IL-18 SNPs and RA susceptibility. However, the frequency of the T allele at rs360722 was found to be significantly lower in patients with RA compared with controls, although this finding was based on only 2 studies. The results of our meta-analysis suggest that IL-18 rs360722 SNP is only associated with RA susceptibility. However, due to only two studies included in our meta-analysis, large-scale well designed studies should be considered in future studies to confirm the exact role of IL-18 rs360722 SNP in RA susceptibility.     

Role of electroencephalogram and oxygen saturation in the induction mechanism of arousal for obstructive sleep apnea-hypopnea syndrome patients

Arousal concomitant with obstructive sleep apnea-hypopnea syndrome (OSAHS) is known to result in sleep fragmentation and excessive daytime sleepiness. The cause of arousal is multifarious, and the mechanism is not yet clear. The aim of this study was to further research the induction mechanism of arousal by investigating the variation of electroencephalogram (EEG) and oxygen saturation (SaO₂). This study enrolled 20 subjects with a clinical diagnosis of OSAHS who underwent overnight polysomnography. Respiratory events and arousals were scored, and individuals with insufficient samples (<30) were excluded. Thus, 13 subjects mostly with severe OSAHS were analyzed in this study. The wavelet coefficients, spectral power of EEG (C4-M1 and C3-M2) before arousal or airway reopening, and the maximum desaturations of SaO₂ during respiratory events were analyzed. For most subjects, EEG (in stages N1 and N2) during respiratory events with arousals exhibited significantly lower values of wavelet coefficients and spectral power (p < 0.05). The maximum desaturations of SaO₂ during respiratory events with arousals are larger than those without among individual. In binary logistic regression analysis, the P values of EEG features and SaO₂ desaturation were both less than 0.001. Our results demonstrate that in light NREM stage, less activity in EEG during respiratory events and larger SaO₂ drop both independently were related to the occurrence of arousal. These significant differences come from major subjects based on the statistical analysis, and help supplement the induction mechanism of arousal.     

Association between ADAM33 S2 and ST+4 polymorphisms and susceptibility to asthma: A meta-analysis

Objective

The aim of this study was to determine whether ADAM33 (a disintegrin and metalloproteinase domain 33) polymorphisms confer susceptibility to asthma in different populations.

Methods

We performed a meta-analysis on the association between the ADAM33 S2, ST+4, F+1, S1, and V4 polymorphisms and asthma.

Results

Thirteen studies in ten reports, which included 4942 patients and 7933 controls, were available for the meta-analysis. Meta-analysis stratified by ethnicity indicated an association between the ADAM33 S2 2 allele and asthma in Europeans (OR = 0.912, 95% CI = 0.851–0.977, p = 0.009). Meta-analysis revealed an association between asthma and the ADAM33 ST+4 2 allele (OR = 0.783, 95% CI = 0.762–0.999, p = 0.048). Stratification by ethnicity indicated an association between the ADAM33 ST+4 polymorphism and asthma in Asians. Stratification by age indicated an association between the ADAM33 ST+4 2 allele and asthma in adults (OR = 0.863, 95% CI = 0.782–0.964, p = 0.008). However, no association was found between asthma and the ADAM33 F+1, S1, and V4 polymorphisms.

Conclusions

This meta-analysis demonstrates that the ADAM33 S2 polymorphism confers susceptibility to asthma in Europeans and the ADAM33 ST+4 polymorphism is associated with asthma in Asians and adults.     

药物干预和手术切除治疗儿童阻塞性睡眠呼吸暂停低通气综合征的疗效评估

目的:对比分析药物干预和手术切除治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效。方法:应用随机数字表法将2015年2月至2017年11月经本院确诊的100例OSAHS患儿分为药物组、手术组,每组50例。药物组采用孟鲁司特钠治疗6个月,手术组行腺样体和扁桃体切除术。6个月后比较两组患儿多导睡眠图监(PSG)的监测结果和生活质量情况,比较两组疗效评定情况,记录手术组无效及并发症的原因。结果:6个月后,药物组、手术组患儿呼吸暂停低通气指数(AHI)、阻塞性呼吸暂停指数(OAI)、微觉醒指数(MAI)和睡眠呼吸紊乱指数(RDI)较治疗前降低,且手术组患儿AHI低于药物(P0.05)。手术组患儿6个月后睡眠障碍、对监护人的影响、身体症状评分较治疗前降低,且低于药物组(P0.05),而药物组治疗前后OSA-18评分各指标比较差异无统计学意义(P0.05)。手术组患儿总有效率为90.00%(45/50),高于药物组的50.00%(25/50),差异有统计学意义(P0.05)。手术组患儿有出血现象的4例、伴舌后坠2例、上呼吸反复道感染6例和鼻炎5例,无效的5例患儿为伴有肥胖的重度OSAHS。结论:对于OSAHS患儿,药物干预和手术切除均可改善患儿PSG指标水平,但手术切除治疗可提高患儿生活质量和治疗有效率。     

Association of a serotonin transporter gene (SLC6A4) 5-HTTLPR polymorphism with body mass index categories but not type 2 diabetes mellitus in Mexicans

The serotonergic system has been hypothesized to contribute to the biological susceptibility to type 2 diabetes mellitus (T2DM) and body-mass index (BMI) categories. We investigate a possible association of 5-HTTLPR polymorphism (L and S alleles) in the promoter region of the serotonin transporter gene (SLC6A4) with the development of T2DM and/or higher BMI by analyzing a sample of 138 individuals diagnosed with T2DM and 172 unrelated controls from the Mexican general population. In the total sample genotypes were distributed according to Hardy-Weinberg equilibrium, and S allele frequency was 0.58. There was no statistical association between 5-HTTLPR polymorphism and the development of T2DM in this Mexican population sample (p = 0.12). Nevertheless, logistic regression analysis of the L allele and increased BMI disclosed an association, after adjusting for age, sex and T2DM (p = 0.02, OR 1.74, 95% CI: 1.079–2.808).     

儿童与成人阻塞型睡眠呼吸暂停低通气综合征代谢异常特征的比较

目的：探讨儿童及成人阻塞型睡眠呼吸暂停低通气综合症（OSAHS）发病原因、睡眠呼吸紊乱严重程度及合并代谢异常程度的差别。方法：对我院2003年1月1日至20]0年7月1日71例诊断为OSAHS住院患者进行回顾性调查,登记年龄、性男日、发病原因、血压、白细胞计数、中性粒细胞比率、淋巴细胞比率、呼吸暂停低通气指数（AHI）、夜间最低血氧饱和度、微觉醒指数。根据年龄进行分组,年龄〈18岁者为A组,年龄≥18岁者为B组。比较两组发病原因、睡眠呼吸紊乱及合并代谢异常程度的差剐。结果：1．A组慢性扁桃体炎和（或）腺样体肥大发生率明显高于B组（P〈O．01）,鼻中隔偏曲发生率明显低于B组（P〈0．01）。2．与B组比较,A组AHI及微觉醒指数降低,夜间最低血氧饱和度升高（P〈0．01）;3．与B组比较,A组高血压、中性粒细胞比率、谷丙转氨酶比例降低（P〈0．05）。结论：A组睡眠呼吸紊乱程度及代谢异常较B组程度轻,更需关注成人阻塞型睡眠呼吸暂停低通气综合症的综合治疗。     

Association between apolipoprotein E gene polymorphism and the risk of multiple sclerosis: A meta-analysis of 6977 subjects

Epidemiological studies have evaluated the association between apolipoprotein E (ApoE) gene polymorphism and multiple sclerosis (MS) risk. However, the results remain conflicting. Therefore, in order to derive a more precise association of ApoE gene polymorphism with MS risk, we performed this meta-analysis. Systematic searches of electronic databases PubMed, Embase and Web of Science, as well as hand searching of the references of identified articles were performed. Twenty studies were identified, covering a total of 4080 MS cases and 2897 controls. The results showed evidence for significant association between ApoE ε2 mutation and MS risk (for ε2/ε4 versus ε3/ε3: OR = 1.74, 95% CI = 1.12–2.71, p = 0.01; for ε2 allele versus ε3 allele: OR = 1.16, 95% CI = 1.01–1.35, p = 0.04). In the subgroup analysis by ethnicity, the similar results were obtained among Europeans (for ε2/ε4 versus ε3/ε3: OR = 1.81, 95% CI = 1.14–2.87, p = 0.01; for ε2 allele versus ε3 allele: OR = 1.19, 95% CI = 1.02–1.38, p = 0.03). After excluding the outlier studies by observing Galbraith plot, marginal association was found between ApoE ε3/ε4 genotype and the protective factor for MS (for ε3/ε4 versus ε3/ε3: OR = 0.86, 95% CI = 0.75–0.99, p = 0.04). In summary, the present meta-analysis provides evidence that ApoE ε2 mutation is associated with MS risk. In addition, ApoE ε3/ε4 genotype appears to be a protective factor for MS.     

睡眠中间歇低氧伴高血压患者与不同血管紧张素转换酶基因型关系的研究

目的探讨睡眠中间歇低氧-阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴高血压患者与血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性的关系。方法采用聚合酶链反应技术对2009年1月至2009年12月沈阳医学院奉天医院经多导睡眠监测(PSG)诊断为OSAHS且伴高血压的51例患者(试验组)及60例健康人进行ACE基因型检测,分析ACE基因型(ID组、II组及DD组)与OSAHS伴高血压患者之间关系。结果与对照组相比,试验组DD基因型显著高于II和ID基因型,等位基因频率D显著高于I(P<0.01),收缩压、舒张压、呼吸暂停低通气指数(AHI)水平显著高于对照组(P<0.01),夜间平均血氧饱和度(平均SaO2)显著低于对照组(P<0.01)。试验组中DD基因型频率显著升高(P<0.01),与ID、II基因型对比,收缩压及AHI均显著升高(P<0.05,P<0.01),平均SaO2显著低于对照组(P<0.05),男患多见(P<0.01)。随AHI增加,D等位基因表达增高,收缩压显著升高,平均SaO2显著降低。结论OSAHS伴高血压患者与ACE基因DD基因型相关,D等位基因可能为易感基因。OSAHS是高血压的独立危险因素,OSAHS越重,血压越高,且男性多发。     

Association of the interleukin-10 − 592A/C, − 1082G/A and − 819T/C gene polymorphisms with type 2 diabetes: A meta-analysis

There is more evidence that interleukin-10 (IL-10), as a multifunctional regulatory cytokine of inflammatory responses, may have an important role in type 2 diabetes (T2D). However, genetic association studies that evaluated the relationship between IL-10 gene variants and T2D have produced conflicting results. The aim of this study was to determine whether the IL-10 gene polymorphisms (− 592A/C, − 1082G/A, − 819T/C) conferred susceptibility to T2D through a meta-analysis. A comprehensive search was conducted to examine all the eligible studies. A total of 9 studies involving 2838 T2D patients and 2773 controls were considered in the meta-analysis. Overall, there was no significant association between IL-10 − 592A/C and T2D (A vs C: OR = 0.93, P = 0.625; AA + AC vs CC: OR = 0.89, P = 0.511; AA vs AC + CC: OR = 0.93, P = 0.821). We failed to find the association between the IL-10 − 1082G allele and T2D (OR = 1.04, P = 0.430), but the genotypes of the IL-10 − 1082G/A polymorphism conferred a risk for the development of T2D (GA vs AA: OR = 1.21, P = 0.027; GG + GA vs AA: OR = 1.17, P = 0.048). Analysis of the − 819T/C polymorphism revealed no significant association with T2D (T vs C: OR = 1.04, P = 0.853; TT + TC vs CC: OR = 1.07, P = 0.834; TT vs TC + CC: OR = 1.08, P = 0.824). In conclusion, the present meta-analysis suggests association between the IL-10 − 1082G/A polymorphism and T2D. However, additional well-designed and larger scale primary studies are required to further evaluate the IL-10 gene polymorphisms and T2D.     

硫辛酸对阻塞性睡眠呼吸暂停低通气综合征患者睡眠呼吸情况及相关生化指标的影响

目的:探讨硫辛酸对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠呼吸情况及相关生化指标的影响。方法:选取石家庄市第一医院收治的OSAHS患者60例,采用随机数字表法分为对照组(n=30)和观察组(n=30)。对照组给予常规治疗,观察组在对照组基础上口服硫辛酸胶囊,疗程为12周。对比两组患者的临床疗效、爱泼沃斯嗜睡量表(ESS)评分,睡眠呼吸情况、糖脂代谢、肝功能及氧化应激指标水平。结果:与对照组比较,观察组治疗后的有效率升高,ESS评分降低(P0.05)。与对照组比较,观察组治疗后呼吸暂停低通气指数(AHI)、脉压(PP)降低,最长呼吸暂停时间缩短,血氧饱和度(SaO2)水平升高(P0.05)。与对照组比较,观察组治疗后空腹血糖、餐后2 h血糖、谷草转氨酶(AST)、甘油三酯(TG)、谷丙转氨酶(ALT)、总胆固醇(TC)、碱性磷酸酶(ALP)、丙二醛(MDA)水平降低,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平升高(P0.05)。结论:采用硫辛酸治疗OSAHS患者具有较好的临床疗效,能够改善患者睡眠呼吸情况及肝功能,调节糖脂代谢,降低氧化应激反应。     

An Updated Meta-Analysis of the Association between Tumor Necrosis Factor-α -308G/A Polymorphism and Obstructive Sleep Apnea-Hypopnea Syndrome

Background

Several studies have reported that the tumor necrosis factor-α (TNF-α) -308G/A polymorphism is associated with susceptibility to obstructive sleep apnea-hypopnea syndrome (OSAHS). However, these results are controversial and conflicting.

Objective

To evaluate the association between TNF-α-308G/A and OSAHS risk by meta-analysis.

Methods

Electronic databases, including PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu, were searched to identify relevant studies. Data were extracted from the included studies. A model-free approach using odds ratio (OR), generalized odds ratio (ORG) and 95% confidence interval (CI) of the allele contrast to assess the association between the -308G/A polymorphism and OSAHS risk. Cumulative and recursive cumulative meta-analyses (CMA) were also carried out to investigate the trend and stability of effect sizes as evidence accumulated.

Results

Seven studies including 1369 OSAHS patients and 1064 controls were identified in this meta-analysis. Significant associations were derived from the variants of the allele contrast [(OR, 1.78; 95% CI, 1.45–2.18) or (ORG, 2.01; 95% CI, 1.27–3.19). CMA showed a trend of an association. Recursive CMA indicated that more evidence is needed to conclude on the status of significance. No significant publication bias was found.

Conclusions

Our meta-analysis suggested that the TNF-α-308G/A polymorphism contribute to the risk of OSAHS. Further studies with larger sample should be performed to confirm our findings.