阻塞性睡眠呼吸暂停低通气综合征合并2型糖尿病患者CXCL13，KIM-1，CTRP5，Klotho表达水平及其临床意义
| 作者: |
1,2朱育年,
2孔朝红,
2江健
1 黄石市第二医院神经内科，湖北 黄石 435000 2 武汉大学人民医院&湖北省人民医院神经内一科，武汉 430060 |
| 通讯: |
孔朝红
Email: kongzhaohong@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2020.03.023 |
| 基金: | 吴阶平医学基金(320.6750.19092-23)。 |
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)合并2型糖尿病(type 2 diabetes mellitus，T2DM)患者的肾损伤因子-1(kidney injury molecule 1，KIM-1)、趋化因子配体13(chemokine ligand 13，CXCL13)、补体C1q/肿瘤坏死因子相关蛋白5(C1q/tnf-associated protein 5，CTRP5)及Klotho表达水平及临床意义。方法：选择2017年3月至2019年1月武汉大学人民医院收治的OSAHS合并T2DM者(合并组)50例、单独OSAHS者(OSAHS组)46例、单独T2DM者(T2DM组)52例，并以同期来我院正常体检的健康人50例作为对照组。比较各组受试者呼吸参数、血脂、血糖、尿KIM-1及血清CXCL13，CTRP5，Klotho水平变化，采用Pearson法对空腹血糖(fasting blood glucose，FBG)、呼吸紊乱指数(apnea hypopnea index，AHI)与尿KIM-1及血清CXCL13，CTRP5，Klotho指标相关性进行分析，并通过受试者工作特征曲线(ROC)分析KIM-1，CXCL13，CTRP5及Klotho对OSAHS合并T2DM患者的诊断价值。结果：与对照组比较，合并组、OSAHS组以及T2DM组尿KIM-1及血清CXCL13，CTRP5升高，血清Klotho水平降低(均P<0.001)；与OSAHS组以及T2DM组比较，合并组患者上述指标改变明显(P<0.05)。与T2DM组比较，合并组和OSAHS组患者M-SaO2，L-SaO2明显降低，SIT90，AHI明显升高(P<0.001)；与OSAHS组比较，合并组患者FBG和HbA1c水平明显升高(均P<0.001)。OSAHS合并T2DM患者FBG，AHI均与尿KIM-1及血清CXCL13，CTRP5水平呈现正相关，与Klotho水平呈现负相关(P<0.001)。结论：尿KIM-1及血清CXCL13，CTRP5，Klotho指标与OSAHS和T2DM患者发生发展关系密切，对OSAHS合并T2DM均具有一定的诊断价值，但联合诊断价值更高。
关键词：
阻塞性睡眠呼吸暂停低通气综合征合并2型糖尿病；趋化因子配体13；肾损伤因子-1；补体C1q/肿瘤坏死因子相关蛋白5；Klotho
Expressions of CXCL13, KIM-1, CTRP5 and Klotho in OSAHS patients with type 2 diabetes mellitus and their clinical significance
CorrespondingAuthor: KONG Zhaohong Email: kongzhaohong@163.com
DOI: 10.3978/j.issn.2095-6959.2020.03.023
Foundation: This work was supported by Wu Jieping Medical Foundation, China (320.6750.19092-23).
Abstract
Objective: To investigate the expression levels of kidney injury molecule 1 (KIM-1), chemokine ligand 13 (CXCL13), complement C1q/tnf-associated protein 5 (CTRP5) and Klotho in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with type 2 diabetes mellitus (T2DM) patients and their clinical significance. Methods: Fifty cases of OSAHS combined with T2DM (combined group), 46 cases of OSAHS alone (OSAHS group), 52 cases of T2DM alone (T2DM group) and 50 cases healthy persons admitted to the department of otolaryngology of our hospital from March 2017 to January 2019 were selected as the control group. Comparing the respiratory parameters, blood fat and blood sugar, urine KIM-1 serum CXCL13, CTRP5, Klotho level change of each groups of. Then using the method of Pearson, fasting blood glucose (FBG), apnea hypopnea index (AHI) and urine and serum CXCL13, CTRP5, KIM-1 Klotho index correlation analysis, and through the receiver-operating characteristic curve (ROC) analysis, CXCL13, CTRP5 and KIM-1 Klotho value to the diagnosis of OSAHS combined T2DM patients. Results: Compared with the control group, urine kim-1, serum CXCL13 and CTRP5 in the combined group, OSAHS group and T2DM group were increased, and serum Klotho level was decreased (all P<0.001). Compared with OSAHS group and T2DM group, patients in the combined group showed significant improvement in the above indicators (P<0.05). Compared with T2DM group, m-sao2 and l-sao2 were significantly decreased in the combined group and OSAHS group, while SIT90 and AHI were significantly increased (all P<0.001). Compared with OSAHS group, FBG and HbA1c levels of patients in the combined group were significantly increased (all P<0.001). FBG, AHI OSAHS combined T2DM patients with urine and serum CXCL13 KIM-1, rendering is related to the level of CTRP5 is negatively related to the level of Klotho. Conclusion: Urinary KIM-1 and serum CXCL13, CTRP5, Klotho indicators are closely related to the occurrence and development of OSAHS and T2DM disease, and have certain diagnostic value for OSAHS combined with T2DM, and the combined diagnosis value is higher.
Keywords：
obstructive sleep apnea hypopnea syndrome combined with type 2 diabetes mellitus; chemokine ligand 13; kidney injury molecule 1; C1q/tnf-associated protein 5; Klotho