Role Of Asprosin And Neuregulin-4 In Serum In Obstructive Sleep Apnea Hypopnea Syndrome

Objective:To detect the expression of Asprosin in serum and explore the clinical value of Asprosin in obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods:A total of 60 adult patients diagnosed with OSAHS by polysomnography（PSG）in the Department of Respiratory and Critical Care Medicine,the first Affiliated Hospital of the University of South China from December 2020 to December 2021 were enrolled.OSAHS patients were divided into mild group（22 cases）,moderate group（18cases）and severe group（20 cases）.21 healthy subjects with age,sex and body mass index（BMI）matched with OSAHS patients during the same period were enrolled as the control group（Controls）.Triglyceride（TG）,blood pressure,neck circumference,BMI,apnea hypopnea index（AHI）and lowest arterial oxygen saturation(LSa O₂)of each group were recorded.The levels of Asprosin and Neuregulin-4 in serum were detected by enzyme-linked immunosorbent assay（ELISA）,and the differences of Asprosin and Neuregulin-4 levels among groups were analyzed and compared.The correlation between serum Asprosin and Neuregulin-4 levels and blood pressure,neck circumference,BMI,TG,AHI and LSa O₂was analyzed.And the diagnostic value of Asprosin and Neuregulin-4 in tuberculous pleurisy were analyzed by ROC curve to evaluate whether the levels could provide a new theoretical basis for clinical diagnosis,severity assessment and treatment of OSAHS.Results:1.There were no significant differences in age,gender and blood pressure between OSAHS groups and the controls.TG,BMI,AHI and neck circumference of the total OSAHS group were significantly higher than those of the controls and LSa O₂was significantly lower than that of the controls（77.0（53.0-85.0）vs.81（79.3-85）,P<0.05;77.0（57.5-78.5）vs.81（79.3-85）,%,P<0.05）.The LSa O₂in the moderate and severe OSAHS group was significantly lower than that in the mild OSAHS group,while AHI,BMI,and neck circumference were significantly higher than those in the mild OSAHS group,and the difference was statistically significant（P<0.05）.However,only AHI in the severe OSAHS group was significantly higher than that in the moderate OSAHS group（52.0±3.6 vs.21.6±1.4,P<0.001）.2.Compared with the controls,the level of Asprosin in serum in the total OSAHS group was significantly higher（179.4±18.8 vs.41.9±10.7,ng/ml,P<0.01）,the level of Asprosin in mild,moderate and severe OSAHS groups was significantly higher than that in the controls and the difference was statistically significant（P<0.001）.Compared with the controls,the level of Neuregulin-4 in serum was significantly decreased in total OSAHS group（707.6±20.0 vs.916.7±67.1,ng/ml,P<0.01）.the level of Neuregulin-4 in mild,moderate and severe OSAHS groups were significantly lower than those in the controls and the difference was statistically significant（P<0.05）.3.Compared with the controls,with the increase of the severity of OSAHS,the expression level of Asprosin gradually increased.The level of Asprosin in the severe OSAHS group was significantly higher than that in the mild OSAHS group（P<0.05）.There were no significant differences in Asprosin levels between the OSAHS group and the moderate OSAHS group,and between the moderate OSAHS group and the mild OSAHS group.Compared with the controls,with the increase of the severity of OSAHS,the expression level of Neuregulin-4 gradually increased,and the difference was statistically significant（P<0.05）.There was no significant difference in the level of Neuregulin-4 among the groups.4.The level of Asprosin was positively correlated with AHI and BMI（r=0.360,P=0.003;r=0.281,P=0.023）.There was no significant correlation between Asprosin and neck circumference,TG,and blood pressure The level of Neuregulin-4 was positively correlated with neck circumference and diastolic blood pressure（r=0.264,P=0.037）,but had no correlation with AHI,BMI,LSa O₂,TG and systolic blood pressure.5.According to the ROC curve,the cut-off value of Asprosin in serum was 69.5 ng/ml,and its sensitivity for diagnosis of OSAHS was81.8%,and its specificity was 96.4%,AUC=0.943,the cut-off value of Neuregulin-4 in serum was 953.2ng/ml.ml,its sensitivity for diagnosis of OSAHS was 40.0%,and its specificity was 96.7%,AUC=0.702.Conclusion:Serum Asprosin may be have a certain value for the clinical diagnosis of OSAHS.The relationship between Neuregulin-4 and OSAHS is still unclear and needs further study.