Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (6): 80-84.doi: 10.6040/j.issn.1673-3770.0.2022.290

• Clinical Study • Previous Articles     Next Articles

The correlation between γ-glutamyl transferase and obstructive sleep apnea syndrome-related hypertension

WANG Teng, YU Lin, LI Sui   

  1. Department of Otolaryngology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
  • Published:2023-12-15

PDF (PC)

208

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

CLC Number: 

  • R76
[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
[1] YUAN Yuqi, CAO Zine, NIU Xiaoxin, XIE Yushan, SU Yonglong, ZHU Simin, ZHANG Yitong, LIU Haiqin, REN Xiaoyong, SHI Yewen. Clinical significance of peripheral blood inflammatory markers in obstructive sleep apnea hypopnea syndrome with hypertension [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 85-92.
[2] ZHANG Yuhuan, ZHANG Junbo, YIN Guoping, YUAN Xuemei, CAO Xin, SUN Yu, CHEN Qiang, YE Jingying. Comparative analysis of polysomnography parameters between the first and second halves of the night in snoring patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 112-117.
[3] CHEN Shangli, QIN Tao, CHEN Xuan, CHEN Ruojin, TANG Zhi. Association between homocysteine concentration and the MTHFR C677T polymorphism and hypertension in patients with obstructive sleep apnea hypopnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 126-133.
[4] SHI Xiaoli, MU Hong. Multidisciplinary diagnosis and treatment of a child with severe obstructive sleep apnea syndrome complicated by pulmonary hypertension [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 116-119.
[5] JI Di, DENG Anchun. Meta-analysis of the effect of surgery for obstructive sleep apnea hypopnea syndrome on blood pressure [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 92-98.
[6] ObjectiveTo analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). MethodsThis was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. ResultsThere were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). ConclusionsAmong the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.. Association between the classification of blood pressure and retinal vessel diameter measured by SD-OCTFENG Xue1, WANG Haiwei2, LI Wensi1, YANG Xintong1, SUN Cun1, ZHAO Yuan1, ZHAO Pengbo1, ZHANG Jianqiang1 1. Department of Ophthalmology, Beijing Moslem People's Hospital, Beijing 100054, China; 2. Department of Ophthalmology, Fuxing Hospital, Capital Medical University, Beijing 100038, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 64-68.
[7] Obstructive sleep apnea syndrome(OSAS)and laryngopharyngeal reflux disease(LPRD)are two common diseases in otolaryngology. In recent years, with the increasing incidence, these diseases have affected the health of more and more people. As research on these two diseases continues to expand, the correlation between them has captured the attention of a number of scholars. In this study, we reviewed the recently published literature on the two diseases, concluding that there is a correlation between them. We have also elaborated on the factors and mechanisms of their mutual influence, analyzed the existing treatment methods of OSAS and LPRD, and provided new ideas for further refinement of the diagnosis and treatment.. Advances in the study of obstructive sleep apnea syndrome and laryngopharyngeal reflux diseaseWANG Hongyan, WANG SanchunOverview TENG Bo, GE Min Guidance Department of Otolaryngology Head & Neck Surgery, the Second Hospital of Jilin University, Changchun 130022, Jilin, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 134-138.
[8] SONG Fan, HUANG Weijun, XU Huajun, GUAN Jian, YI Hongliang. Relationship between carotid elasticity and oxidative stress in patients with obstructive sleep apnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 99-104.
[9] JI Di, CHEN Xiang, YU Lin. Soft palate surgeries with hyoid bone suspension for obstructive sleep apnea hypopnea syndrome with glossoptosis: a meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 124-130.
[10] Min YIN,Lei CHENG. Comments and opinions on the nomenclature of snoring disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 19-22.
[11] HU An, XING Yanli, CHEN Xiaoping, XUE Xiaocheng, ZHANG Yi, XU Weihua. Treatment of coexisting obstructive sleep apnea and laryngopharyngeal reflux disease and analysis of its characteristic reflux symptom index and reflux finding score [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 86-89.
[12] LIU Bei, LÜ Bochang, ZHU Zhongqiao, SUN Jianhua. Protective effect of puerarin on the optic nerve in rats with chronic intraocular hypertension [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 98-103.
[13] LIU Dawei, ZHANG Yu, LI Chenglin, CHEN Xiumei, SONG Xicheng. Use of enhanced recovery after surgery in children with obstructive sleep apnea syndrome during the perioperative period [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 19-22.
[14] SU Jie, AI Xin, MA Chunmei, YANG Fuyu, HUANG Shuai. Relationship between acute intraocular hypertension and lateral geniculate neuron autophagy and apoptosis in rats [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 68-71.
[15] CHEN Xuan, HAN Li, FAN Chuanfeng, LI Yingmei, LIU Jian, SHU Xiangwen, WANG Yu. Expression of endothelin-1 in plasma of patients with hypertensive retinopathy in essential hypertension. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(6): 78-80.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] MA Bao-feng,DANG Guang-fu .

Trans-scleral suture fixation in implantation of foldable intraocular lenses

[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(4): 376 -378 .
[2] FENG Xin-rong,ZHANG Hong-xia,XU Zhen-ji,QU Jun-jun, . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(3): 225 -226 .
[3] ZHANG Qiu-gui,HE Hai-yan . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(6): 520 -521 .
[4] LI Hai-yan,ZHAO Qiu-liang,HAN Xiao-pan,YU li . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(6): 527 -529 .
[5] SONG Xi-cheng,ZHANG hua,ZHANG Qing-quan . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(5): 385 -387 .
[6] ZHAN Shan-qiang,KONG Fan-li,CAO Wen-juan,TANG Jie . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(6): 559 -560 .
[7] ZHANG Hu,AI Qin . Re-operation for thyroid cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(2): 166 -167 .
[8] HU Ming,LI Zhao-na,LI Yun-jie ,TAO Xiang-chen . Effect of rigid gas permeable contact lens on keratoconus[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(2): 171 -173 .
[9] LOU Feng . Effect of bilateral superior laryngeal nerve block on preventing cardiovascular reaction[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(2): 173 -175 .
[10] CHEN Wei-Xiong, WANG Yue-Jian, CENG Yong, HE Fa-Yao, ZHANG Jian-Li, ZHENG Li-Gang, TANG Su-Cheng. Clinical experience of no-insufflation endoscopic thyroidectomy by a small incision upon the sternum[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2009, 23(4): 24 -26 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd