Zhongguo quanke yixue (Oct 2023)
The Level of Adipokine Metrnl and Its Relationship with Inflammation and Insulin Resistance in Patients with Obstructive Sleep Apnea Syndrome
Abstract
Background Obstructive sleep apnea syndrome (OSAS) patients have severe multisystem metabolic disorders in the body, with a high comorbidity rate with various metabolic diseases and poor prognosis. The adipokine Metrnl is a newly identified target for regulating lipid and glycolipid metabolism. The correlation of Metrnl with OSAS and OSAS-related metabolic disorders has been rarely reported. Objective To observe the differences of adipokine Metrnl in patients with OSAS, and explore its relationship with inflammation and insulin resistance caused by OSAS. Methods A total of 119 participants who were hospitalized and physically examined in the geriatric department of the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology from 2021 to 2022, were selected and divided into the mild OSAS group (n=57), moderate-to-severe OSAS group (n=26) and control group (n=62) according to the results of standard polysomnography monitoring. General data of the 3 groups was collected, including fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin A1c (HbA1c), uric acid (UA), Metrnl, nuclear factor-κB (NF-κB), IL-6, TNF-α, IL-10 and IL-4 levels. The homeostatic model assessment for insulin resistance (HOMA-IR) was used to assess insulin resistance. Results BMI in the moderate-to-severe OSAS group was higher than the control group and mild OSAS group (P<0.05) ; FINS level in the moderate-to-severe OSAS group was higher than the mild OSAS group and control group, and FINS level in the mild OSAS group was higher than the control group (P<0.05) ; Metrnl level of the moderate-to-severe OSAS group was lower than the mild OSAS group and control group, and Metrnl level in the mild OSAS group was lower than the control group (P<0.01) ; NF-κB, TNF-α, IL-6, and HOMA-IR in the OSAS group were higher than the control group, TNF-α and HOMA-IR in the moderate-to-severe OSAS group were higher than the mild OSAS group and control group, TNF-α and HOMA-IR in the mild OSAS group were higher than the control group (P<0.01), IL-10 in the OSAS group was lower than the control group (P<0.01). Partial correlation analysis showed that Metrnl level was negatively correlated with NF-κB (r=-0.30), IL-6 (r=-0.40), TNF-α (r=-0.37), HOMA-IR (r=-0.36), FBG (r=-0.32), HbA1c (r=-0.33) and AHI (r=-0.51), and positively correlated with IL-10 (r=0.27) (P<0.05). Multiple linear regression analysis showed that IL-6, TNF-α, HOMA-IR were independent influencing factors for Metrnl level (P<0.05) . Conclusion The expression level of Metrnl is reduced in OSAS patients and negatively correlated with the severity of OSAS. HOMA-IR, IL-6, TNF-α are independent influencing factors for Metrnl level in OSAS patients.
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