山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (3): 38-44.doi: 10.6040/j.issn.1673-3770.0.2024.037

• 上海市第六人民医院耳鼻咽喉头颈外科献礼“六院120周年”纪念专题 • 上一篇    

犬尿氨酸介导阻塞性睡眠呼吸暂停所致肝功能损伤:一项横断面研究

卫志成,彭裕,沈力,李莉琳,沈杭东,李馨仪,许华俊,关建   

  1. 上海交通大学医学院附属第六人民医院 耳鼻咽喉头颈外科/上海市睡眠呼吸障碍疾病重点实验室/上海交通大学耳鼻咽喉科研究所/上海市第六人民医院临床研究中心, 上海 200233
  • 发布日期:2025-06-04
  • 通讯作者: 关建. E-mail:guanjian0606@sina.com
  • 基金资助:
    国家自然科学基金项目(81970870、82271153);上海市中医药三年行动计划(2021-2023)项目ZY(2021-2023)-0205-04;上海交通大学医工(理)交叉基金项目(YG2023LC11)

Kynurenine mediates liver injury induced by obstructive sleep apnea: a cross-sectional study

WEI Zhicheng, PENG Yu, LI Lilin, SHEN Hangdong, LI Xinyi, XU Huajun, GUAN Jian   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine / Shanghai Key Laboratory of Sleep Disordered Breathing / Otorhinolaryngology Institute of Shanghai JiaoTong University / Clinical Research Center of Shanghai Sixth People's Hospital, Shanghai 200233, China
  • Published:2025-06-04

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摘要： 目的 犬尿氨酸是色氨酸代谢途径重要产物,介导多种病理生理活动。本研究旨在探究阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)严重程度及肝功能损伤与血清犬尿氨酸的关系。 方法 从2019年1月至2019年6月因打鼾就诊于上海交通大学医学院附属第六人民医院睡眠中心的200例疑似OSA受试者中筛选出142例患者纳入研究。收集人体测量数据、生化指标、睡眠监测数据,并检测血清犬尿氨酸、吲哚胺-2,3-双加氧酶1(indoleamine-2,3-dioxygenase 1, IDO1)、丙氨酸氨基转移酶(alanine aminotransferase, ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase, AST)水平。分析评估睡眠参数、犬尿氨酸、ALT和AST之间的相关性因素及中介因素。 结果 线性回归分析在校正性别、年龄、体重指数(body mass index, BMI)后结果显示, 呼吸暂停-低通气指数(apnea-hypopnea index, AHI)、最低氧饱和度(lowest oxygen saturation, LSpO2)、氧饱和度指数(oxygen desaturation index, ODI)、犬尿氨酸是ALT的独立相关因素;AHI、平均氧饱和度(mean oxygen saturation, MSpO2)、LSpO2、ODI、睡眠时氧饱和度低于90%的时间占总监测时间的百分比(the cumulative sleep time at SpO2<90%,CT90)、犬尿氨酸是AST的独立相关因素。中介分析显示,犬尿氨酸可分别解释AHI、MSpO2、LSpO2和ODI对OSA患者血清AST影响的50.0%、43.0%、54.4%和52.4%。 结论 犬尿氨酸在OSA引起的肝功能损伤中发挥着重要的中介作用,可能是一种潜在的治疗靶点。

关键词: 阻塞性睡眠呼吸暂停, 肝功能损伤, 犬尿氨酸, 色氨酸代谢

Abstract: Objective Kynurenine is an important product of the tryptophan metabolic pathway, which mediates a variety of pathophysiological activities. This study aims to investigate the relationship between serum kynurenine and the severity of obstructive sleep apnea(OSA)and liver function damage. Methods From January to June 2019, 142 subjects with suspected OSA were selected from 200 subjects who visited the Sleep Center of the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine due to snoring. Anthropometric data, biochemical indicators, and sleep monitoring data were collected, and serum kynurenine, indoleamine-2,3-dioxygenase 1(IDO1), Alanine Aminotransferase(ALT), and Aspartate Aminotransferase(AST)levels were detected. The correlation and mediating factors between sleep parameters, kynurenine, ALT, and AST, were analyzed and evaluated. Results After adjusting for gender, age, and body mass index(BMI), linear regression analysis revealed that apnea-hypopnea index(AHI), lowest oxygen saturation(LSpO2), oxygen desaturation index(ODI), and kynurenine were independent related factors for ALT. AHI, mean oxygen saturation(MSpO2), LspO2, ODI, the cumulative sleep time at SpO2<90%(CT90), and kynurenine were independent risk factors for AST. Mediation analysis showed that kynurenine could explain 50.0%, 43.0%, 54.4%, and 52.4% of the effects of AHI, MSpO2, LSpO2, and ODI on serum AST in OSA patients, respectively. Conclusion Kynurenine plays an important mediating role in OSA-induced liver function damage and may be a potential therapeutic target.

Key words: Obstructive sleep apnea, Liver function injury, Kynurenine, Tryptophan metabolism

中图分类号: 

  • R766
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