Changes And Significance Of NGAL And Lp-PLA2 In Childr En With Obstructive Sleep Apnea Hypopnea Syndrome

Background and ObjectiveObstructive sleep apnea hypopnea syndrome(OSAHS)is a phenomenon of increased airway dilatation resistance and sleep fragmentation caused by periodic stenosis or obstruction of the upper respiratory tract.Most of the children with OSAHS are disturbed sleep at night,snoring,mouth breathing,repeated awakening,sweating,enuresis,daytime sleepiness,reduced activity,abnormal weight change,growth and development retardation,distraction,cognitive dysfunction and so on.At present,the common diagnostic methods include physical examination,head and neck CT imaging examination,multi-party questionnaire survey of children and parents,and Polysomnography(PSG)recording apnea hypopnea index(AHI)during nighttime sleep.At present,no specific serological diagnosis and grading indicators have been found in the diagnosis and progress of OSAHS at home and abroad.However,the disadvantages of traditional OSAHS diagnosis methods such as long time and high cost lead to low acceptance of children’s families.Neutrophil gelatinase-associated lipocalin(NGAL)is an acute phase protein,mainly secreted by neutrophil granulocytes.When acute inflammatory injury occurs in the body,NGAL can be rapidly increased in a short time and can be detected in serum and urine.Lipoprotein-associated phospholipase A2(Lp-PLA2)is a hydrolase produced by mononuclear macrophages and activated under hypoxia.It is involved in vascular injury and other pathological reactions through the degradation of platelet activators.Superoxide dismutase(SOD-1)is a protective protease that can scavenge oxygen free radicals and other cytotoxic substances to resist oxidative stress under hypoxic conditions.By studying the changes of peripheral blood metabolism-related indexes,NGAL,Lp-PLA2 and other body injury markers in children with OSAHS,the significance of their changes in the occurrence and progression of diseases in children with OSAHS was discussed.MethodsA total of 122 children with OSAHS hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2018 to October 2020 were selected as the OSAHS group.Fifty healthy children who underwent physical examination in our hospital during the same period were selected as the control group.According to the diagnostic criteria for the severity of disease in children with OSAHS in the Clinical Practice Guidelines of the American Academy of Pediatrics,the children with OSAHS were divided into mild group,moderate group and severe group.The significance of serum metabolism-related indexes and body injury markers in the occurrence of OSAHS disease and different severity of OSAHS disease were investigated by comparing serum metabolism-related indexes and body injury markers in each group.SPSS 21.0 statistical software was used for statistical analysis,and general data,metabolism-related indicators and injury markers were compared between the OSAHS group and the control group.Metabolism-related indexes and injury markers in different severity groups of OSAHS children were compared.The correlation between injury markers and AHI in children with OSAHS was analyzed.P<0.05 was considered statistically significant.Results1.OSAHS group and the control group there was no statistically significant difference of gender,age,BMI(P>0.05).2.Serum low density lipoprotein(LDL),high density lipoprotein(HDL),triglyceride(TG)and glucose(GLU)in the OSAHS group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).Total cholesterol(TC)in the OSAHS group was no statistically significant difference compared with control group(P>0.05).3.The body injury markers NGAL and Lp-PLA2 in the OSAHS group were significantly higher than those in the control group,with statistical significance(P<0.05).The superoxide dismutase(SOD-1)in OSAHS group was significantly lower than that in control group,and the difference was statistically significant(P<0.05).4.According to the severity of disease in children with OSAHS,the serum metabolism-related indexes LDL,HDL,TG and GLU showed statistically significant differences among the three groups(P<0.05).TC was no statistically significant difference among three groups(P>0.05);Pair-to-pair comparison showed that LDL,TG and Glu were significantly increased with the severity of OSAHS.HDL decreased significantly with the severity of OSAHS.5.According to the severity of disease in children with OSAHS,the body damage markers NGAL,Lp-PLA2 and SOD-1 were significantly different among the three groups(P<0.05).Pairwise comparison showed that NGAL and Lp-PLA2 were significantly increased with the severity of OSAHS.Pairwise comparison showed that SOD-1 decreased significantly with the severity of OSAHS.6.The injury markers NGAL and Lp-PLA2 were positively correlated with apnea hypopnea index(AHI)(P<0.05).SOD-1 was negatively correlated with AHI(P<0.05).Conclusions1.Children with OSAHS have abnormal blood glucose and lipid metabolism,which are closely related to the severity of the disease.2.NGAL,Lp-PLA2 and SOD-1 are involved in the occurrence and progression of OSAHS,which are closely related to the severity of OSAHS,and can provide a basis for defining the progression of OSAHS.3.High NGAL,Lp-PLA2 and low SOD-1 suggest that OSAHS may be aggravated in children with OSAHS,and the hypoxia status in children with OSAHS may be worsened by participating in vascular injury and systolic dysfunction.