Correlation Between Serum ANGPTL3,ANGPTL8 Levels And Glucolipid Metabolism In Patients With Obstructive Sleep Apnea

Objective:This study was conducted to determine the levels of ANGPTL3,ANGPTL4 and ANGPTL8 in the family of angiopoietin-like proteins(ANGPTLs)in patients with obstructive sleep apnea(OSA),to investigate their correlation with sleep monitoring indicators and glucose and lipid metabolism indicators and whether they could be independent risk factors for OSA,to elucidate the clinical significance of ANGPTL3,ANGPTL4 and ANGPTL8 in OSA patients,and to provide a theoretical basis for the pathogenesis of metabolic diseases and cardiovascular diseases(CVDs)in OSA patients.Methods:Patients who underwent nocturnal polysomnography(PSG)at the Sleep Monitoring Unit of the Department of respiratory of our hospital from December 2021 to May 2022 were collected.A total of 81 subjects were selected according to the inclusion and exclusion criteria,including 19 simple snorers with apnea hypopnea index(AHI)<5events/h as the control group and 62 OSA patients with AHI ≥5 events/h as the OSA group.Subjects’ sleep monitoring indicators were recorded,and the levels of ANGPTL3,ANGPTL4 and ANGPTL8 in plasma samples were measured by enzyme-linked immunosorbent assay(ELISA).At the same time,indexes related to glucose and lipid metabolism of patients were determined by professional clinical laboratory physicians in the biochemical room of clinical laboratory.Results:1.The levels of FINS,HOMA-IR,TG,LDL-C,ANGPTL3,ANGPTL8 were significantly higher and the level of HDL-C was significantly lower,in the OSA group compared to the control(P<0.05).Age,gender,FPG,TC and ANGPTL4 showed no significant differences between the control group and the OSA group(P>0.05).2.The levels of AHI,FINS,HOMA-IR,TG,ANGPTL8 were significantly higher in the obese group compared with the non-obese group(P<0.05).The differences in age,gender,FPG,TC,HDL-C,LDL-C,ANGPTL3 and ANGPTL4 were not statistically significant in the obese group of OSA patients compared with the non-obese group(P>0.05).3.In the OSA group,ANGPTL3 was positively correlated with AHI,FINS,HOMA-IR,TG and ANGPTL8,and was negatively correlated with HDL-C(P<0.05).ANGPTL3 had no significant correlation with FPG,TC,LDL-C and ANGPTL4(P>0.05).4.In the OSA group,ANGPTL8 was positively correlated with AHI,TG and ANGPTL3,and was negatively correlated with HDL-C(P<0.05).ANGPTL8 had no significant correlation with FPG,FINS,HOMA-IR,TC,LDL-C and ANGPTL4(P>0.05).5.Multivariate logistic regression analysis showed that ANGPTL3 was independently associated with OSA after adjusting for established risk factors(OR=1.129,95%CI,1.025-1.244;P<0.05).That is,for every 1ng/ml increase in ANGPTL3,the patient’s risk of developing OSA becomes 1.129 times greater.On the contrary,after adjusting for existing risk factors,no significant correlation was found between ANGPTL8 levels and OSA.Conclusion:1.OSA patients have disorders of glucolipid metabolism.Obesity not only increases the severity of OSA patients,but also has a synergistic effect in the activation of glucolipid metabolic pathways in OSA.In addition,obesity affects the expression of ANGPTL8 in OSA patients.2.The levels of ANGPTL3 and ANGPTL8 are elevated in patients with OSA,and these two proteins are closely related to the severity of OSA,so we speculate that the elevation of ANGPTL3 and ANGPTL8 may be due to CIH.3.ANGPTL8 may be associated with disorders of lipid metabolism in OSA patients.ANGPTL3 may be associated with disorders of glucolipid metabolism in OSA patients.Multivariate logistic regression analysis suggested that serum ANGPTL3 may be an independent risk factor for the development of OSA.Therefore,ANGPTL3 and ANGPTL8 are indicators for the evaluation of OSA,and are important factors associated with abnormal glucose and lipid metabolism in OSA patients.