中重度阻塞性睡眠呼吸暂停低通气综合征患者血清神经肽Y和人生长激素释放多肽变化与认知功能的关系
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摘要
目的:探讨中重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,O S A H S)患者血清神经肽Y (n e u ro p e p t i d eY, N P Y)、人生长激素释放多肽变化与认知功能的关系。方法:选择110例OSAHS患者作为试验组,其中中度组30例,重度组80例;另选择同时期40例单纯鼾症患者作为对照组。比较各组血清NPY和人生长激素释放多肽水平,记录各组MoCA和MMSE评分以评估患者的认知功能,并分析NPY,人生长激素释放多肽(Ghrelin)与认知功能的相关性。结果:试验组血清NPY水平均显著高于对照组,差异具有统计学意义(P<0.05);重度组NPY水平高于中度组(P<0.05)。试验组血清Ghrelin水平均显著低于对照组,差异具有统计学意义(P<0.05);重度组低于中度组(P<0.05)。三组Mo CA与MMSE总评分差异具有统计学意义(P<0.05);其中重度组MoCA与MMSE总评分明显低于对照组和中度组(P<0.05)。患者MoCA总评分与血清NPY水平呈负相关(r=-0.562,P<0.05),与血清Ghrelin水平呈正相关(r=0.469,P<0.05);MMSE总评分与血清NPY水平呈负相关(r=-0.431,P<0.05),与血清Ghrelin水平呈正相关(r=0.386,P<0.05)。结论:OSAHS可引起患者血清NPY和Ghrelin水平变化,对患者的认知功能有一定损害,血清肽类物质的改变与患者认知功能相关。
Objective: To investigate the relationship between changes of serum neuropeptide Y(NPY), ghrelin and cognitive function in patients with moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods: A total of 110 patients with OSAHS were divided into a moderate group(n=30) and a severe group(n=80). Forty snoring patients were selected as a control group. The levels of serum neuropeptide Y and ghrelin were compared between the groups. The MoCA and MMSE scores of each group were recorded to evaluate the cognitive function. The correlation between NPY, ghrelin and cognitive function was analyzed. Results: Serum NPY level of OSAHS patients was significantly higher than that in the control group(P<0.05). Meanwhile,the NPY level in the severe group was higher than that in the moderate group(P<0.05). The ghrelin level of OSAHS patients was significantly lower than that in the control group, and the difference was statistically significant(P<0.05). The ghrelin level in the severe group was lower than that in the moderate group(P<0.05).The MoCA and MMSE scores of three groups were significantly different(P<0.05). The MoCA and MMSE scores of the severe group were significantly lower than those of the control group and the moderate group(P<0.05). The MoCA score of patients was negatively correlated with serum NPY level(r=-0.562, P<0.05), and positively correlated with serum ghrelin level(r=0.469, P<0.05). The MMSE score was negatively correlated with serum NPY level(r=–0.431, P<0.05), positively correlated with serum ghrelin level(r=0.386, P<0.05).Conclusion: OSAHS can cause changes of serum NPY and ghrelin levels. OSAHS is harmful to the cognitive function of the patients. The changes of serum peptides are related to cognitive function.
Objective: To investigate the relationship between changes of serum neuropeptide Y(NPY), ghrelin and cognitive function in patients with moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods: A total of 110 patients with OSAHS were divided into a moderate group(n=30) and a severe group(n=80). Forty snoring patients were selected as a control group. The levels of serum neuropeptide Y and ghrelin were compared between the groups. The MoCA and MMSE scores of each group were recorded to evaluate the cognitive function. The correlation between NPY, ghrelin and cognitive function was analyzed. Results: Serum NPY level of OSAHS patients was significantly higher than that in the control group(P<0.05). Meanwhile,the NPY level in the severe group was higher than that in the moderate group(P<0.05). The ghrelin level of OSAHS patients was significantly lower than that in the control group, and the difference was statistically significant(P<0.05). The ghrelin level in the severe group was lower than that in the moderate group(P<0.05).The MoCA and MMSE scores of three groups were significantly different(P<0.05). The MoCA and MMSE scores of the severe group were significantly lower than those of the control group and the moderate group(P<0.05). The MoCA score of patients was negatively correlated with serum NPY level(r=-0.562, P<0.05), and positively correlated with serum ghrelin level(r=0.469, P<0.05). The MMSE score was negatively correlated with serum NPY level(r=–0.431, P<0.05), positively correlated with serum ghrelin level(r=0.386, P<0.05).Conclusion: OSAHS can cause changes of serum NPY and ghrelin levels. OSAHS is harmful to the cognitive function of the patients. The changes of serum peptides are related to cognitive function.
引文
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8.Shi L,Wang H,Wei L,et al.Pharyngeal constrictor muscle fatty change may contribute to obstructive sleep apnea-hypopnea syndrome:Aprospective observational study[J].Acta Otolaryngol,2016,136(12):1285-1290.
9.王晓琼,高华.阻塞性睡眠呼吸暂停低通气综合征病人的肥胖程度与血浆神经肽Y的相关性研究[J].蚌埠医学院学报,2017,42(3):320-322.WANG Xiaoqiong,GAO Hua.The correlational study of obesity degree with serum neuropeptide Y level in patients with obstructive sleep apnea hypopnea syndrome[J].Journal of Bengbu Medical College,2017,42(3):320-322.
10.赵晓雨,刘淑红,赵彤,等.强噪声对豚鼠认知功能和血清某些生化指标的影响[J].中国应用生理学杂志,2016,32(5):385-389.ZHAO Xiaoyu,LIU Shuhong,ZHAO Tong,et al.Effects of strong noise on cognitive function and serum biochemical parameters in guinea pigs[J].Chinese Journal of Applied Physiology,2016,32(5):385-389.
11.Sawano E,Iwatani K,Tominaga-Yoshino K,et al.Reduction in NPY-positive neurons and dysregulation of excitability in young senescenceaccelerated mouse prone 8(SAMP8)hippocampus precede the onset of cognitive impairment[J].J Neurochem,2015,135(2):287-300.
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13.Wei H,Cao X,Zeng Q,et al.Ghrelin inhibits proinflammatory responses and prevents cognitive impairment in septic rats[J].Crit Care Med,2015,43(5):e143-150.
14.Cahill SP,Taylor H,Alfonso A,et al.An examination of early neural and cognitive alterations in hippocampal-spatial function of ghrelin receptor-deficient rats[J].Behav Brain Res,2014,264:105-115.
15.刘维英,余勤,张佳宾,等.阻塞性睡眠呼吸暂停低通气综合征血浆β内啡肽神经肽Y及人生长激素释放多肽的变化及其与情绪相关性研究[J].中国实用内科杂志,2012,32(6):468-470.LIU Weiying,YU Qin,ZHANG Jiabin,et al.Changes of plasma betaendorphin neuropeptide Y and human growth hormone-releasing polypeptide in patients with obstructive sleep apnea-hypopnea syndrome and their relationship with mood[J].Chinese Journal of Practical Internal Medicine,2012,32(6):468-470.
16.Huang R,Han J,Tian S,et al.Association of plasma ghrelin levels and ghrelin rs4684677 polymorphism with mild cognitive impairment in type 2 diabetic patients[J].Oncotarget,2017,8(9):15126-15135.
17.Kunath N,Müller NC,Tonon M,et al.Ghrelin modulates encodingrelated brain function without enhancing memory formation in humans[J].Neuroimage,2016,142:465-473.
2.孟志玲,王小琴.阻塞性睡眠呼吸暂停综合征的口腔医学研究现状[J].全科口腔医学电子杂志,2018,5(4):4-5.MENG Zhiling,WANG Xiaoqin.Current status of oral medicine in obstructive sleep apnea syndrome[J].Electronic Journal of General Stomatology,2018,5(4):4-5.
3.Nakamura M,Yanagihara M,Matsui K,et al.Brain microstructural alterations in patients with severe obstructive sleep apnea:a preliminary diffusion tensor imaging study[J].Sleep Biol Rhythms,2017,15(4):331-335.
4.Gilani S,Quan SF,Pynnonen MA,et al.Obstructive sleep apnea and gastroesophageal reflux:a multivariate population-level analysis[J].Otolaryngol Head Neck Surg,2016,154(2):390-395.
5.于悦,肖莉.阻塞性睡眠呼吸暂停低通气综合征与代谢综合征的关系及研究现状[J].国际呼吸杂志,2018,38(6):469-473.YU Yue,XIAO Li.Relationship between obstructive sleep apneahypopnea syndrome and metabolic syndrome and its current research[J].International Journal of Respiration,2018,38(6):469-473.
6.中华医学会呼吸病学分会睡眠呼吸疾病学组.阻塞性睡眠呼吸暂停低通气综合证诊治指南(草案)[J].中华结核和呼吸杂志,2002,25(4):195-198.Sleep Respiratory Diseases Group,Society of Respiratory Diseases,Chinese Medical Association.Guidelines for the diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome(draft)[J].Chinese Journal of Tuberculosis and Respiration,2002,25(4):195-198.
7.唐旋,杨立新,张梅,等.OSAHS患者认知功能状况及其与血清神经肽Y水平的相关性研究[J].临床耳鼻咽喉头颈外科杂志,2018,32(18):1414-1417.TANG Xuan,YANG Lixin,ZHANG Mei,et al.Cognitive status and its relationship with serum neuropeptide Y in patients with obstructive sleep apnea hypopnea syndrome[J].Journal of Clinical Otolaryngology Head and Neck Surgery,2018,32(18):1414-1417.
8.Shi L,Wang H,Wei L,et al.Pharyngeal constrictor muscle fatty change may contribute to obstructive sleep apnea-hypopnea syndrome:Aprospective observational study[J].Acta Otolaryngol,2016,136(12):1285-1290.
9.王晓琼,高华.阻塞性睡眠呼吸暂停低通气综合征病人的肥胖程度与血浆神经肽Y的相关性研究[J].蚌埠医学院学报,2017,42(3):320-322.WANG Xiaoqiong,GAO Hua.The correlational study of obesity degree with serum neuropeptide Y level in patients with obstructive sleep apnea hypopnea syndrome[J].Journal of Bengbu Medical College,2017,42(3):320-322.
10.赵晓雨,刘淑红,赵彤,等.强噪声对豚鼠认知功能和血清某些生化指标的影响[J].中国应用生理学杂志,2016,32(5):385-389.ZHAO Xiaoyu,LIU Shuhong,ZHAO Tong,et al.Effects of strong noise on cognitive function and serum biochemical parameters in guinea pigs[J].Chinese Journal of Applied Physiology,2016,32(5):385-389.
11.Sawano E,Iwatani K,Tominaga-Yoshino K,et al.Reduction in NPY-positive neurons and dysregulation of excitability in young senescenceaccelerated mouse prone 8(SAMP8)hippocampus precede the onset of cognitive impairment[J].J Neurochem,2015,135(2):287-300.
12.Fernandes FR,Apolinário D,Esquinas AM.Obstructive sleep apnea hypopnea syndrome and pulmonary embolism:warfarin versus positive airway pressure as determinant[J].Chin Med J(Engl),2016,129(2):251-252.
13.Wei H,Cao X,Zeng Q,et al.Ghrelin inhibits proinflammatory responses and prevents cognitive impairment in septic rats[J].Crit Care Med,2015,43(5):e143-150.
14.Cahill SP,Taylor H,Alfonso A,et al.An examination of early neural and cognitive alterations in hippocampal-spatial function of ghrelin receptor-deficient rats[J].Behav Brain Res,2014,264:105-115.
15.刘维英,余勤,张佳宾,等.阻塞性睡眠呼吸暂停低通气综合征血浆β内啡肽神经肽Y及人生长激素释放多肽的变化及其与情绪相关性研究[J].中国实用内科杂志,2012,32(6):468-470.LIU Weiying,YU Qin,ZHANG Jiabin,et al.Changes of plasma betaendorphin neuropeptide Y and human growth hormone-releasing polypeptide in patients with obstructive sleep apnea-hypopnea syndrome and their relationship with mood[J].Chinese Journal of Practical Internal Medicine,2012,32(6):468-470.
16.Huang R,Han J,Tian S,et al.Association of plasma ghrelin levels and ghrelin rs4684677 polymorphism with mild cognitive impairment in type 2 diabetic patients[J].Oncotarget,2017,8(9):15126-15135.
17.Kunath N,Müller NC,Tonon M,et al.Ghrelin modulates encodingrelated brain function without enhancing memory formation in humans[J].Neuroimage,2016,142:465-473.