Abstract:

Objective To investigate the correlations between serum γ⁃glutamyl transferase（γ⁃GT）and carotid atherosclerosis in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods A total of 153 patients who received polysomnography（PSG）from March 2016 to July 2019 were enrolled and divided into control group（n = 51），mild to moderate OSAHS group（n = 58），and severe OSAHS group（n = 44）based on sleep apnea hypopnea index（AHI）. According to carotid intima⁃media thickness（CIMT），they were divided into carotid sclerosis group and non⁃carotid sclerosis group. The differences in the general clinical data，PSG monitoring indexes and biochemical indexes were compared between the groups. The correlation analysis between CIMT and the related indexes was performed，and multivariate Logistic regression analysis was further performed. Results There were significant differences between the three groups in terms of the body mass index（BMI），proportion of hypertension，systolic blood pressure（SBP），diastolic blood pressure（DBP），AHI，oxygen deoxygenation index （ODI），the time when oxygen saturation was below 90% in the sleeping period（TS90%），the lowest nocturnal finger oxygen saturation（L⁃SaO2），triglyceride（TG），fasting blood glucose（FPG），γ⁃GT and CIMT（P < 0.05）. The serum γ⁃GT levels in the severe OSAHS group，the mild⁃moderate OSAHS group and the control group were（41.45 ± 7.14），（34.50 ± 6.62）and（25.26 ± 5.31）U/L，respectively（P < 0.001）. Compared with the non⁃carot⁃ id atherosclerosis group，SBP，AHI，ODI，TS90%，TG，LDL⁃C，FPG，γ⁃GT levels were all significantly higher in the carotid atherosclerosis group，and L⁃SaO2 levels were significantly lower in the carotid atherosclerosis group （P < 0.05）. The serum γ⁃GT levels in the carotid and non⁃carotid atherosclerosis groups were（36.27 ± 6.21）and （28.45 ± 6.39）U/L，respectively（P < 0.001）. Pearson correlation analysis showed that CIMT was positively corre⁃ lated with age，SBP，AHI，ODI，TS90%，TG，FPG，γ⁃GT（P < 0.05），and CIMT was negatively correlated with L⁃SaO2（P < 0.05）. Spearman rank correlation showed that CIMT was positively correlated with hypertension（P < 0.05）. Multiple Logistic regression showed that increased serum γ⁃GT level was an independent risk factor for carotid atherosclerosis in the OSAHS patients（OR = 2.124，P < 0.001）. Conclusion Serum γ⁃GT level gradually may increase with the severity of OSAHS patients，and be positively correlated with CIMT. Serum γ⁃GT level is an inde⁃ pendent predictor of OSAHS patients with carotid atherosclerosis，which is of great significance for clinical practice.

Key words:

γ ? glutamyl transferase, carotid atherosclerosis, obstructive sleep apnea hypopnea syn? drome, carotid intima media thickness, correlation