Relationship between serum copeptin,adropin and sleep structure and carotid atherosclerosis in patients with ob-structive sleep apnea hypopnea syndrome
Objective To explore the relationship between serum and peptide(copeptin),energy balance related protein(adropin),sleep structure and carotid atherosclerosis(AS)in patients with obstructive sleep apnea hypopnea syn-drome(OSAHS).Methods Collect 178 OSAHS patients diagnosed and treated in the Respiratory Department of the Sec-ond Hospital of Shanxi Medical University from May 2021 to May 2023.Divide OSAHS patients into mild group(n=52),moderate group(n=80),and severe group(n=46)according to different degrees of illness,and compare the serum levels of copeptin,adropin,and sleep structure of OSAHS patients with different degrees of illness;Pearson test was used to analyze the correlation between serum copeptin,adropin,and sleep structure in OSAHS patients;Multivariate logistic regression model was used to analyze the influencing factors of AS occurrence in OSAHS patients;The predictive value of receiver operating characteristic(ROC)curve analysis of serum copeptin and adropin for the occurrence of AS in OSAHS patients.Results The serum copeptin,sleep latency,and number of awakenings in the mild,moderate,and severe groups all in-creased in sequence,while serum adropin,total sleep time,and rapid eye movement sleep as a percentage of total sleep time(REM%)all decreased in sequence(F=25.130,52.510,100.580,218.980,45.310,59.140,P<0.001).Serum copeptin levels in OSAHS patients were positively correlated with sleep latency and number of awakenings,but negatively correlated with to-tal sleep time and REM%(r=0.675,0.570,-0.685,-0.590,all P<0.001);The serum adiposin levels in OSAHS patients were positively correlated with total sleep time and REM%,and negatively correlated with sleep latency and number of awaken-ings(r=0.539,0.683,-0.568,-0.631,all P<0.001);Multivariate analysis showed that elevated serum copeptin,elevated AHI,concomitant hypertension,and smoking history were risk factors for developing AS in OSAHS patients,while elevated serum adropin was a protective factor[OR(95%CI)=1.905(1.226-2.808),1.585(1.093-2.076),1.881(1.280-2.730),1.696(1.195-2.553),0.552(0.396-0.770),all P<0.01];The area under the curve(AUC)for predicting the occurrence of AS in pa-tients with obstructive sleep apnea(OSAHS)were 0.745,0.780,and 0.877,respectively,using serum copeptin,adropin,and their combination.The combined AUC of the two was greater than that of single detection(Z/P=4.234/0.006,3.861/0.011).Conclusion Elevated serum copeptin and decreased adiposin can lead to sleep disorder in OSAHS patients and promote the formation of cervical atherosclerosis.The combined detection of these two indicators has high predictive value for the formation of cervical atherosclerosis in OSAHS patients.
维普
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