阻塞性睡眠呼吸暂停低通气综合征患者血清脂联素水平与其认知功能的相关性

摘要

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者血清脂联素(adiponectin,APN)水平与其认知功能的相关性.方法 选取我院就诊的OSAHS患者94例作为OSAHS组,同时从健康体检中心选取非OSAHS健康人群93例作为正常对照组.收集其人口学资料及临床检验指标,采用酶联免疫吸附测定(enzymes linked immunosorbent assay,ELISA)法检测血清APN水平.采用36导多导睡眠图监测仪进行睡眠呼吸监测.用重复性成套神经心理状态测验量表(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS)和简易精神状态量表(Mini-Mental State Examinatlon,MMSE)进行认知功能评定.结果 ①与正常组相比,OSAHS组血清APN水平降低,RBANS认知功能量表评分包括即刻记忆、视觉广度、注意力、延迟记忆及总分均下降;②OSAHS患者血清APN与体质量指数、胰岛素抵抗指数、呼吸暂停低通气指数、氧分压<90%占监测时间的百分比呈负相关,与平均氧饱和度呈正相关;③在OSAHS患者中,与非认知功能障碍组相比,认知功能障碍组血清APN水平降低;④经Logistic回归分析发现,APN是OSAHS患者认知功能的保护性因素(OR=0.212,P=0.008);⑤APN与OSAHS患者RBANS认知功能量表评分包括即刻记忆、注意力、延迟记忆及总分呈正相关.结论 OSAHS患者血清APN水平及认知功能评分均降低,且APN水平与认知功能评分呈正相关,是其认知功能的保护性因素,提示血清APN水平下降可能参与了OSAHS患者认知功能受损的发生及发展过程.%Objective To investigate the association of serum adiponectin(APN) levels with cognitive function in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 94 patients with OSAHS cared at our hospital and 93 healthy controls without OSAHS from the medical examination center were recruited.Data on demographic characteristics and clinical parameters were collected.APN was measured by enzymes linked immunosorbent assay(ELISA).Cognitive performance was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS) and Mini-Mental State Examinatlon(MMSE).Results ①Compared with controls, Serum APN levels and RBANS scores including immediate memory, visuospatial/constructional, attention, delayed memory and total scores were all lower in patients with OSAHS.②APN was negatively correlated with body mass index, Homeostasis model assessment for insulin resistance, apnea hypoventilation index and % night-time spent with oxygen saturation<90%, but postively correlated with mean oxygen saturation.③In patients with OSAHS, cognitive impairment group had lower levels of APN than non-cognitive impairment group.④Logistic regression analysis showed that APN was a protective factor of cognitive function in patients with OSAHS(OR=0.212, P=0.008);⑤APN was postively correlated with RBANS scores including immediate memory, attention, delayed memory and total scores in patients with OSAHS.Conclusion Patients with OSAHS have lower serum APN levels and worse cognitive performance, and serum APN was postively correlated with their cognitive performance, suggesting that serum APN may be involved in cognitive deficits of patients with OSAHS.