The Changes And Implications Of Serum Klotho Levels In Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Objective To observe the changes of serum Klotho protein levels in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and to explore the relationship between serum Klotho protein levels and the severity of OSAHS and coronary heart disease(CHD).Methods Basic clinical data were collected from 66 subjects(44 males and 22 females),height and weight were recorded and body mass index was calculated.All subjects denied the history of liver and kidney dysfunction,tumor and other diseases,and the history of acute and chronic infection in the past month.The patients were divided into three groups:control group(n = 16),mild to moderate OSAHS group(n = 23)and severe OSAHS group(n = 27).The age and sex of the patients in each group were balanced and comparable.The level of serum Klotho protein was detected by ELISA method,and the statistical analysis was carried out by SPSS 22.0 software.The difference significance test was defined as P<0.05.The correlation between Klotho protein level and each index was analyzed.At the same time,the subgroups of OSAHS patients with or without coronary heart disease were analyzed.Results There was no significant difference in age,sex composition，total cholesterol(TC),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C)among the three groups,and there was no significant difference between the three groups in serum TC,HDL-C,LDL-C.The serum level of triglyceride(TG)in severe OSAHS group was higher than that in control group(P<0.05).There were significant differences in body mass index(BMI),oxygen desaturation index(ODI)and lowest oxygen saturation(LSpO2)among the three groups(P<0.05).The serum Klotho protein levels in patients with mild to moderate OSAHS 2.12±0.61μg/L = and severe OSAHS group(1.83±0.53μg/L)were significantly lower than those in control group(2.56±0.92μg/L)(P<0.05).Univariate correlation analysis of Klotho protein level showed a negative correlation with age,AHI and ODI(P<0.05),and a positive correlation with LpSO2 and MSpO2.In the subgroup analysis,the serum Klotho protein concentration in OSAHS with coronary heart disease group(1.67±0.44)was significantly lower than that without coronary heart disease group(2.28±0.55)(P<0.01).Multiple stepwise regression analysis showed that AHI index and coronary heart disease were independent risk factors for Klotho protein level except age.Conclusion 1.The level of serum Klotho protein in patients with OSAHS was lower than that in control group.With the increase of AHI and hypoxia,the level of serum Klotho protein decreased gradually.2.The level of Klotho protein in OSAHS patients with coronary heart disease was significantly lower than that in patients with OSAHS alone.3.Both AHI and coronary heart disease are independent influencing factors of serum Klotho protein level,which may promote the occurrence and development of coronary heart disease by influencing the level of Klotho protein.