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| 阻塞性睡眠呼吸暂停低通气综合征患者骨密度及血清OPG、RANKL的变化 |
| The changes of bone mineral density and serum OPG and RANKL in obstructive sleep apnea hypopnea syndrome patients |
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| DOI：10.3969/j.issn.1006.7108.2017.09.001 |
| 中文关键词: 阻塞性睡眠呼吸暂停低通气综合征 骨质疏松 骨密度 OPG RANKL |
| 英文关键词:Obstructive sleep apnea hypopnea syndrome Osteoporosis Bone mineral density OPG RANKL |
| 基金项目:江西省青年科学基金资助项目（20161BAB215235） |
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| 中文摘要: |
| 目的 通过测定阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者骨密度及血清骨保护素(osteoprotegerin, OPG)、核因子κ B受体活化因子配体(receptor activator of nuclear factor kappa-B ligand, RANKL)的变化，初步探讨OSAHS与骨质疏松的关系。方法 根据呼吸暂停低通气指数(apnea hypopnea index，AHI)将我院确诊的88名OSAHS患者分为3组：轻度组(5次/h≤AHI<15次/h)30例、中度组(15次/h≤AHI<30次/h)30例、重度组(AHI≥30次/h)28例，并选择30名健康人群作为正常对照组。记录所有受试者一般资料，测定骨代谢指标及腰椎、股骨颈骨密度，采用双抗体夹心酶联免疫吸附法检测各组受试者的血清OPG、RANKL水平，比较各组之间的差异并与AHI进行相关性分析，P<0.05为差异有统计学意义。结果 中度OSAHS组腰椎、股骨颈骨密度较正常对照组降低，差异有统计学意义；重度OSAHS组腰椎、股骨颈骨密度分别较正常对照组、轻度OSAHS组降低，差异有统计学意义。各组OSAHS患者血清OPG均较正常对照组降低，其中重度OSAHS组分别与轻度OSAHS组、正常对照组差异有统计学意义。各组OSAHS患者血清RNAKL均较正常对照组升高，其中中度OSAHS组较正常对照组差异有统计学意义，重度OSAHS组分别较轻度OSAHS组、正常对照组差异有统计学意义。Pearson相关性分析结果显示：骨密度、OPG与AHI呈负相关，RANKL与AHI呈正相关。结论 OSAHS患者有发生骨质疏松的风险，且与缺氧程度密切相关，OPG/RANKL比率下调可能为作用机制之一。 |
| 英文摘要: |
| Objective By studying the changes of bone mineral density (BMD) and serum OPG and RANKL in obstructive sleep apnea hypopnea syndrome (OSAHS) patients, to explore the relationship between OSAHS and osteoporosis preliminarily. Methods According to their apnea hypopnea index (AHI), 88 patients with OSAHS were collected and divided into 3 groups: mild (5≤AHI<15times/h, n=30), moderate (15≤AHI<30times/h, n=30), and severe (AHI≥30times/h, n=28). Thirty healthy persons were selected as control. The general information of the subjects was recorded. Bone metabolic markers and BMD of L1-4 and the femoral neck (Neck) were measured. The expressions of serum OPG and RANKL were determined using ELISA kits. The difference among the groups was compared and the correlation with AHI was analyzed. P<0.05 was considered statistically significant. Results BMD of L1-4 and Neck of patients with moderate and severe OSAHS was significantly lower than that in normal control group and the differene between severe and mild OSAHS is also significant statistically. The serum OPG of patients in each OSAHS group was lower than that in normal control group, and the difference was statististically significant between severe OSAHS patients and mild OSAHS patients, and normal control group, respectively. The serum RANKL of patients in each OSAHS group was higher than that in normal control group, and the differences were statististically significant between moderate OSAHS patients, severe OSAHS patients, and normal control group, and between severe OSAHS patients with normal control group, respectively. The result of Pearson correlation analysis showed that BMD and OPG were negatively correlated with AHI, but RANKL was positively correlated with AHI. Conclusion The risk of suffering from osteoporosis is higher in OSAHS patients than in healthy people, and it is closely related to the degree of hypoxia. The imbalance of OPG and RANKL levels may be one of the main causes of the occurrence and development of OSAHS with osteoporosis. |
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