Objective: Patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) have impaired dynamic cerebral autoregulation (dCA). This study aimed to explore whether serum levels of apolipoprotein B-100 (ApoB-100), fibronectin (FN), and ceruloplasmin (CP) were related to impaired dCA in OSAHS.
Methods: A total of 90 patients with OSAHS from our database management system were enrolled and further divided into three subgroups according to the apnea-hypopnea index (AHI) using polysomnography results: mild (5 ≤ AHI ≤ 15), moderate (15 < AHI ≤ 30), and severe OSAHS (AHI > 30), with 30 patients in each group. Thirty sex- and age-matched healthy controls were recruited for this study. The serum levels of ApoB-100, FN, and CP were measured by enzyme-linked immunosorbent assays. dCA was assessed by analyzing the phase difference (PD) using transfer function analysis.
Results: Serum levels of ApoB-100, FN, and CP were significantly higher in the mild, moderate, and severe OSAHS groups than that in the control group (P < 0.001, respectively). The average PD of the moderate and severe OSAHS groups was lower than that of the control group (P =0.001 and P < 0.001, respectively). Receiver operating curve analysis revealed that ApoB-100, FN, and CP might be able to distinguish patients with OSAHS from healthy individuals (area under the curve = 0.959 [95% CI 0.92– 1.00], 0.987 [95% CI 0.96– 1.01], 0.982 [95% CI 0.96– 1.00]), respectively, P < 0.001). The average PD was linearly correlated with the serum levels of ApoB-100, FN, and CP in patients with OSAHS. Multivariable analysis showed that FN and arousal index in polysomnography were associated with impaired average PD (P < 0.001 and P =0.025, respectively).
Conclusion: Serum levels of ApoB-100, FN, and CP increased in patients with OSAHS. dCA was compromised in patients with OSAHS and was positively correlated with ApoB-100, FN, and CP serum levels, and FN serum levels and arousal index in polysomnography were independently associated with impaired dCA.
Keywords: obstructive sleep apnea-hypopnea syndrome, apolipoprotein B-100, fibronectin, ceruloplasmin, dynamic cerebral autoregulation