Correlation Between Lipid Metabolism Disorder With ANGPTL4 And ANGPTL8 In Patients With OSAHS

Objectives:Study the correlation between obstructive sleep apnea-hypopnea syndrome（OSAHS）and both angiopoietin-like protein 4（ANGPTL4）and angiopoietin-like protein 8（ANGPTL8）,and explore the impact and clinical value of ANGPTL4 and ANGPTL8 on initiation and development of OSAHS,by detecting the expression levels of ANGPTL4and ANGPTL8 in plasma from patients with OSAHS.Methods:1.In accordance with inclusion and exclusion criteria,60cases of initial OSAHS conducted with a polysomnography（PSG）in He Bei general hospital from April 2019 to January 2020 were selected as the OSAHS group,and 28 cases of primary snoring as the control group.Sleep monitoring indexes including apnea hypopnea index（AHI）,the lowest blood oxygen saturation（L-Sp O₂）,Sp O₂<90%of total sleep time percentage（TRTSp O₂<90%）,and oxygen desaturation index（ODI）were recorded.2.General information of participants collected by uniform questionnaires,included but not limited to age,gender,height,weight,neck circumference,waist circumference,hip circumference,prior history,personal history,family history and drug history.3.After morning monitoring,drew fasting venous blood from participants for two tubes of 5ml each.Determined biochemical index like triglyceride（TG）,total cholesterol（TC）,high density lipoprotein（HDL）and low density lipoprotein（LDL）,of one tube sent to clinical laboratory in hospital.By applying enzyme-linked immunosorbent assay（ELISA）,determine the expression levels of ANGPTL4 and ANGPTL8 in the plasma from the other tube.Arranged and analyzed the data by employing statistical methods.Results:1.Compared with control group,the OSAHS group had no significant difference in age and gender（P>0.05）,while indicated a significant increase in BMI,neck circumference and waist-hip ratio（P<0.05）.2.The level of TG,TC,LDL,ANGPTL4 and ANGPTL8 in OSAHS group were higher than that in control group,with only significant increase in TG,ANGPTL4 and ANGPTL8（P<0.05）,while the level of HDL significantly decreased（P<0.05）.3.Contrasted with control group,the levels of AHI,TRTSp O₂<90%,ODI in OSAHS were significantly higher（P<0.001）,and level of L-Sp O₂significantly dropped（P<0.001）.4.It was evident that BMI,neck circumference and waist-hip ratio was positively correlated with AHI in OSAHS（r_s>0,P<0.05）.5.It was evident that TG was positively correlated with AHI（r>0,P<0.001）,HDL was negatively correlated with AHI（r<0,P<0.001）,while TC,LDL have no obvious with AHI.6.It was evident that ANGPTL4 and ANGPTL8 was positively correlated with TG,AHI,TRTSp O₂<90%and ODI（r_s>0,P<0.05）,while negatively correlated with HDL and L-Sp O₂（r_s<0,P<0.05）,have no obvious with TC and LDL.7.The multivariate logistic regression of OSAHS showed that HDL,ANGPTL4 and ANGPTL8 had statistical significance（P<0.05）.1 mmol/L of HDL was associated with a 0.012 times higher risk of OSAHS,1ng/ml of ANGPTL4 was associated with a 2.258 times higher risk of OSAHS,and1pg/ml of ANGPTL8,1.021 times higher risk of OSAHS.8.Analysis based on the prediction of ANGPTL4 and ANGPTL8 for OSAHS revealed that area under the ROC curve of ANGPTL4 reached 0.756,sensitivity 55%,specificity 89.3%;the area under the ROC curve of ANGPTL8 reached 0.822,sensitivity 81.7%,and specificity 71.4%.Conclusions:1.ANGPTL4 and ANGPTL8 maybe contribute to OSAHS combined with lipid metabolism disorder.2.There is an obvious increase in ANGPTL4 and ANGPTL8 of plasma from patients with OSAHS.The more ANGPTL4 and ANGPTL8 levels improve,the more severe OSAHS patients with apnea and hypoxemia will be.3.ANGPTL4 and ANGPTL8 can predict OSAHS to a certain extent.ANGPTL4 is high in specificity,while low in sensitivity;ANGPTL8 high in sensitivity,and low in specificity.