血清γ-谷氨酰基转移酶与阻塞性睡眠呼吸暂停综合征伴发高血压的相关性研究

doi:10.6040/j.issn.1673-3770.0.2022.290

摘要/Abstract

摘要： 目的探讨阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome, OSAHS)患者血清γ-谷氨酰基转移酶(γ-glutamyl transferase, GGT)水平与OSAHS严重程度及高血压的相关性。方法选取行多导睡眠监测的患者312例作为研究对象,根据患者呼吸暂停指数(apnea-hypopnea index, AHI)分为4组:对照组(AHI 0~5)、轻度OSAHS组(AHI 5~15)、中度OSAHS组(AHI 16~30)、重度OSAHS组(AHI >30)。患者入院24 h内测定静脉血GGT,比较组间差异,采用多元逐步回归法分析相关影响因素。根据是否存在高血压,进一步将OSAHS受试者分为合并高血压组和未合并高血压组。比较各组间GGT水平并进行统计学分析,最后采用二分类logistics回归分析血清GGT水平在OSAHS患者合并高血压中的预测作用。结果血清GGT水平与OSAHS严重程度呈正相关,差异有统计学意义(P<0.001);多元逐步回归分析结果显示,血清GGT与氧减指数呈现独立相关性(β=0.557,P<0.001);同时伴有高血压的OSAHS患者血清GGT水平明显高于不伴高血压组,差异有统计学意义(P<0.001);logistics回归分析示血清GGT升高是OSAHS合并高血压的独立预测因子(OR=1.015,P<0.001)。结论血清GGT与OSAHS严重程度呈正相关,并可作为独立危险因素来预测OSAHS患者伴发高血压的可能性。

关键词: 阻塞性睡眠呼吸暂停综合征, γ-谷氨酰基转移酶, 高血压, 预测价值

Abstract: Objective This study aimed to investigate the correlation between serum levels of γ-glutamyl transferase(GGT)and the severity of obstructive sleep apnea syndrome(OSAHS)and hypertension. Methods A total of 312 patients with OSAS who underwent polysomnography were selected as the research subjects. They were divided into four separate groups according to the apnea-hypopnea index(AHI)scores: control group(AHI 0-4), mild OSAS group(AHI 5-15), moderate OSAS group(AHI 16-30), and severe OSAS group(AHI>30). The venous blood GGT was measured within 24 hours after admission, and the differences between groups were compared. The related influencing factors were analyzed by multiple stepwise regression method. The OSAS subjects were further classified into two groups: those with hypertension and those without hypertension. The GGT levels in the groups were compared and statistically analyzed, binary logistic regression was used to analyze the predictive effect of serum GGT level in OSAHS patients with hypertension. Results The serum GGT levels were positively correlated with OSAS severity, and the difference was statistically significant(P<0.001). Multiple stepwise regression analysis showed that serum γ-glutamyl transferase(GGT)was independently correlated with oxygen desaturation index(β=0.557, P<0.001). The level of serum GGT in OSAHS patients with hypertension was significantly higher than that in OSAHS patients without hypertension(P<0.001). The logistic regression analysis showed that elevated serum GGT was an independent predictor of OSAHS with hypertension(OR=1.015, P<0.001). Conclusion The serum GGT levels are positively correlated with the severity of OSAHS and can be used as an independent risk factor to predict the likelihood of developing OSAHS with hypertension.

Key words: Obstructive sleep apnea syndrome, γ-glutamyl transferase, Hypertension, Predictive value

中图分类号:

王腾,余林,李穗. 血清γ-谷氨酰基转移酶与阻塞性睡眠呼吸暂停综合征伴发高血压的相关性研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 80-84.

WANG Teng, YU Lin, LI Sui. The correlation between γ-glutamyl transferase and obstructive sleep apnea syndrome-related hypertension[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 80-84.

参考文献

[1] Franco CM, Lima AM, Ataíde L Jr, et al. Obstructive sleep apnea severity correlates with cellular and plasma oxidative stress parameters and affective symptoms[J]. J Mol Neurosci, 2012, 47(2): 300-310. doi:10.1007/s12031-012-9738-0
[2] Yildirim T, Alp R. The role of oxidative stress in the relation between fibromyalgia and obstructive sleep apnea syndrome[J]. Eur Rev Med Pharmacol Sci, 2017, 21(1): 20-29
[3] Lee DH, Jacobs DR Jr, Gross M, et al. Gamma-glutamyltransferase is a predictor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults(CARDIA)Study[J]. Clin Chem, 2003, 49(8): 1358-1366. doi:10.1373/49.8.1358
[4] Kozakova M, Gastaldelli A, Morizzo C, et al. Gamma-glutamyltransferase, arterial remodeling and prehypertension in a healthy population at low cardiometabolic risk[J]. J Hum Hypertens, 2021, 35(4): 334-342. doi:10.1038/s41371-020-0337-1
[5] 中国医师协会睡眠医学专业委员会. 成人阻塞性睡眠呼吸暂停多学科诊疗指南[J]. 中华医学杂志, 2018, 98(24): 1902-1914. doi:10.3760/cma.j.issn.0376-2491.2018.24.003
[6] 中国高血压防治指南修订委员会.中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019, 24(1): 24-56. doi: 10.3969/j.issn.1007-5410.2019.01.002
[7] KIRSCH D B. Obstructive Sleep Apnea [J]. Continuum(Minneapolis, Minn), 2020, 26(4): 908-928.doi: 10.1212/CON.0000000000000885
[8] Baguet JP, Barone-Rochette G, Pépin JL. Hypertension and obstructive sleep apnoea syndrome: current perspectives[J]. J Hum Hypertens, 2009, 23(7): 431-443. doi:10.1038/jhh.2008.147
[9] Kario K, Hettrick DA, Prejbisz A, et al. Obstructive sleep apnea-induced neurogenic nocturnal hypertension: a potential role of renal denervation? [J]. Hypertension, 2021, 77(4): 1047-1060. doi:10.1161/HYPERTENSIONAHA.120.16378
[10] Abu SL, Rachel S, Cohen JB. Obstructive sleep apnea, hypertension, and cardiovascular risk: epidemiology, pathophysiology, and management[J]. Curr Cardiol Rep, 2020, 22(2): 6.
[11] Torres G. Relationship between OSA and hypertension[J]. Chest, 2015, 148(3): 824-832. doi:10.1378/chest.15-0136
[12] Koseoglu HI, Altunkas F, Demir O, et al. Serum levels of gamma-glutamyl transferase are associated with cardiovascular disease in obstructive sleep apnea syndrome[J]. Ann Saudi Med, 2013, 33(6): 584-590. doi:10.5144/0256-4947.2013.584
[13] Takemura K, Board PG, Koga F. A systematic review of serum γ-glutamyltransferase as a prognostic biomarker in patients with genitourinary cancer[J]. Antioxidants(Basel), 2021, 10(4): 549. doi:10.3390/antiox10040549
[14] Turgut O, Tandogan I. Gamma-glutamyltransferase to determine cardiovascular risk: shifting the paradigm forward[J]. J Atheroscler Thromb, 2011, 18(3): 177-181. doi:10.5551/jat.6189
[15] Gonzaga C, Bertolami A, Bertolami M, et al. Obstructive sleep apnea, hypertension and cardiovascular diseases[J]. J Hum Hypertens, 2015, 29(12): 705-712. doi:10.1038/jhh.2015.15
[16] Schiffrin EL. Compendium on hypertension: the microbiome, inflammation and oxidative stress, the sympathetic nervous system and treatment of hypertension[J]. Am J Hypertens, 2020, 33(10): 889. doi:10.1093/ajh/hpaa159
[17] Pinheiro LC, Oliveira-Paula GH. Sources and effects of oxidative stress in hypertension[J]. Curr Hypertens Rev, 2020, 16(3): 166-180. doi:10.2174/1573402115666190531071924
[18] Sinha N, Dabla PK. Oxidative stress and antioxidants in hypertension-a current review[J]. Curr Hypertens Rev, 2015, 11(2): 132-142. doi:10.2174/1573402111666150529130922
[19] Zhang L, Zhang XL, Meng H, et al. Obstructive sleep apnea and liver injury in severely obese patients with nonalcoholic fatty liver disease[J]. Schlaf Atmung, 2020, 24(4): 1515-1521. doi:10.1007/s11325-020-02018-z
[20] 顾晨鹃, 李敏, 李庆云, 等. 阻塞性睡眠呼吸暂停低通气综合征患者血清γ-谷氨酰基转移酶的变化及其预测意义[J]. 中华结核和呼吸杂志, 2016(8): 592-597. doi: 10.3760/cma.j.issn.1001-0939.2016.08.008 GU Chenjuan, LI Min, LI Qingyun, et al. Serum γ-glutamyltransferase in obstructive sleep apnea hypopnea syndrome and its role in predicting concomitant diabetes mellitus[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2016(8): 592-597. doi: 10.3760/cma.j.issn.1001-0939.2016.08.008
[21] Lee DH, Ha MH, Kim KY, et al. Gamma-glutamyltransferase: an effect modifier in the association between age and hypertension in a 4-year follow-up study[J]. J Hum Hypertens, 2004, 18(11): 803-807. doi:10.1038/sj.jhh.1001742

相关文章 15

[1]	袁钰淇,曹子讷,牛晓欣,谢雨杉,苏永龙,朱思敏,张一彤,刘海琴,任晓勇,施叶雯. 外周血炎症指标在阻塞性睡眠呼吸暂停低通气综合征伴高血压中的临床意义[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 85-92.
[2]	张玉焕,张俊波,尹国平,袁雪梅,曹鑫,孙宇,陈强,叶京英. 鼾症患者前后半夜多导睡眠监测参数的对比分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 112-117.
[3]	陈尚丽,秦涛,陈璇,陈若瑾,唐智. Hcy及其代谢关键酶MTHFR C677T基因多态性与OSAHS患者高血压的相关性研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 126-133.
[4]	季迪,邓安春. 外科干预对阻塞性睡眠呼吸暂停低通气综合征患者血压影响的系统评价[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 92-98.
[5]	冯雪,王海伟,李闻思,杨新同,孙存,赵媛,赵朋波,张建强. 基于SD-OCT分析高血压类型与视网膜血管管径的关系[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 64-68.
[6]	王宏艳,王三春滕博,葛敏. 阻塞性睡眠呼吸暂停综合征与咽喉反流性疾病相关研究进展[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 134-138.
[7]	吴兆坤,朱新华. 腺样体扁桃体切除术治愈儿童阻塞性睡眠呼吸暂停综合征的偏误研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 148-152.
[8]	宋凡,黄炜峻,许华俊,关建,易红良. 阻塞性睡眠呼吸暂停综合征患者颈动脉弹性与氧化应激反应的关系[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 99-104.
[9]	季迪, 陈祥, 余林. 软腭平面手术联合舌骨悬吊术治疗阻塞性睡眠呼吸暂停综合征效果的Meta分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 124-130.
[10]	刘燕,魏萍,寇巍,胡思洁,武小芳,刘萌雅,陈成,姚红兵. 儿童腺样体肥大与耳鼻咽喉科常见疾病关系的研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 149-154.
[11]	闫志刚,张慧慧,于丹,刘岩,文连姬,王迪. 成人阻塞性睡眠呼吸暂停综合征患者认知功能障碍的诊断及治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 155-161.
[12]	殷敏,程雷. 鼾症命名之我见[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 19-22.
[13]	胡安,邢艳莉,陈晓平,薛晓成,张燚,胥伟华. 咽喉反流伴阻塞性睡眠呼吸暂停低通气综合征患者的治疗及其咽喉反流体征评分、症状指数特点[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 86-89.
[14]	刘大炜,张宇,李成林,陈秀梅,宋西成. 加速康复外科在儿童OSAS围手术期中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 19-22.
[15]	陈璇,韩莉,范传峰,栗映梅,刘建,舒相纹,王玉. 高血压视网膜病变患者血浆内皮素-1的表达及意义[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 78-80.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed