| Abstract | Cilj istraživanja: Glavni ciljevi ovog istraživanja su bili usporediti serumske koncentracije katestatina i lipidih parametara u bolesnika s opstrukcijskom apnejom tijekom spavanja (OSA) i kontrolnih ispitanika te utvrditi moguću povezanost katestatina s polisomnografskim i lipidnim parametrima u populaciji OSA bolesnika.
Ispitanici i metode: Ovo presječno kliničko istraživanje provedeno je u Centru za Medicinu spavanja Kliničkog bolničkog centra Split i Medicinskog fakulteta u Splitu tijekom razdoblja od prosinca 2016. do veljače 2018. godine, a uključilo je ukupno 75 odraslih novodijagnosticiranih bolesnika s OSA-om i 50 kontrolnih ispitanika usklađenih prema dobi, spolu i indeksu tjelesne mase. OSA je dijagnosticirana kontinuiranom cjelonoćnom laboratorijskom polisomnografijom (Alice 5LE, Philips Respironics, Eindhoven, Nizozemska) prema važećim praktičnim smjernicama. Svim ispitanicima uzeta je detaljna anamneza te izvršen fizikalni pregled i antropometrijsko mjerenje. Venski uzorci krvi su uzeti natašte za analizu lipidnih parametara i određivanje serumskih koncentracija katestatina metodom dvostrukog enzim-imunoadsorpcijskog testa humanog katestatina (Phoenix Pharmaceuticals, Burlingame, CA, SAD), prema uputstvima proizvođača.
Rezultati: Serumske koncentracije katestatina su značajno više u OSA bolesnika u odnosu na kontrolnu skupinu (2,99 ± 0,14 vs. 1,37 ± 0,13 ng/mL; P<0,001). Katestatin je značajno pozitivno korelirao s AHI indeksom u podskupini OSA bolesnika koji nisu bili pretili (r=0,544; P=0,002 i β=0,481; P=0,022). Serumske koncentracije triglicerida su bile značajno više u OSA bolesnika u odnosu na kontrolnu skupinu (2,02 ± 0,88 vs. 1,51 ± 0,87 mmol/L; P<0,001) kao i frakcije non-HDL-kolesterola (4,98 ± 0,12 vs. 4,60 ± 0,15 mmol/L; P=0,048). Također, OSA bolesnici su imali značajno niže koncentracije HDL-kolesterola u usporedbi s kontrolnom skupinom (1,16 ± 0,03 vs. 1,42 ± 0,05 mmol/L; P<0,001) dok u koncentracijama ukupnog kolesterola i LDL-kolesterola nisu pronađene značajne razlike među skupinama. Utvrđena je statistički značajna negativna korelacija serumskih koncentracija katestatina i HDL-kolesterola u OSA bolesnika (r=-0,466; P<0,001 i β=-0,434; P<0,001). Kao dijagnostički test u detekciji OSA-e, serumski katestatin je postigao vrijednost područja ispod krivulje AUC=0,909, 95% CI 0,841-0,955; P<0,001.
Zaključci: Serumske koncentracije katestatina su značajno više u OSA bolesnika u usporedbi s kontrolnom skupinom te negativno koreliraju sa HDL-kolesterolom, dok u podskupini OSA bolesnika koji nisu pretili katestatin pozitivno korelira s AHI vrijednosti. Konačno, serumski katestatin je demonstrirao visoke dijagnostičke performanse u detekciji OSA statusa. |
| Abstract (english) | Objectives: The aims of the study were to compare serum catestatin concentrations between patients with obstructive sleep apnea (OSA) and control subjects and to determine potential associations of catestatin with polysomnographic and lipid parameters in OSA population.
Patients and methods: This cross-sectional study was conducted at the Split Sleep Medicine Center from December 2016 to February 2018 and included a total of 75 adult newly-diagnosed patients with OSA and 50 control subjects that were body mass index/age/sex-matched. OSA was diagnosed by full-night in-laboratory polysomnography (Alice 5LE, Philips Respironics, Eindhoven, Netherlands) according to established guidelines. A detailed medical history interview along with physical examination and anthropometric measuring were undertaken in each enrolled subject. Venous blood samples were taken from fasting subjects and were used to determine serum catestatin concentrations and lipid profile parameters. Serum catestatin concentrations were determined by an enzyme-linked immunosorbent assay (ELISA) method by using a commercial kit for human catestatin (Phoenix Pharmaceuticals, Burlingame, CA, USA) according to manufacturer's instructions.
Results: Serum catestatin concentrations are significantly higher in OSA patients than in control group (2.99 ± 0.14 vs. 1.37 ± 0.13 ng/mL; P<0.001) and positively correlate with AHI in non-obese OSA patient subgroup (r=0.544; P=0.002 i β=0.481; P=0.022). Serum concentrations of triglycerides and non-HLD-cholesterol fractions were significantly higher in OSA patients compared to control group (2.02 ± 0.88 vs. 1.51 ± 0.87 mmol/L; P<0.001 and 4.98 ± 0.12 vs. 4.60 ± 0.15 mmol/L; P=0.048, respectively). Furthermore, HDL-cholesterol was lower in OSA group when compared to control group (1.16 ± 0.03 vs. 1.42 ± 0.05 mmol/L; P<0.001) and correlated negatively with serum catestatin concentrations (r=-0.466; P<0.001 and β=-0.434; P<0.001). Both groups did not differ in respect to total cholesterol and LDL-cholesterol levels. Serum catestatin provided area under the curve (AUC) value of 0.909 (95% CI 0.841-0.955; P<0.001) for the detection of OSA status.
Conclusions: Serum catestatin concentrations are significantly higher in OSA patients compared to control group and correlate negatively with HDL-cholesterol, while in the non-obese OSA patient subgroup, catestatin positively correlates with AHI values. Finally, serum catestatin demonstrated high diagnostic performance in detection of OSA status. |
