| Background Epidemiological and observational clinical studies have found that insomnia is the risk factor to lead to stroke.Patients with insomnia symptoms can increase the risk of stroke by 54%.However,it is still not certain that the specific mechanism between insomnia and stroke.Atherosclerosis and hypertension are the most common risk factors for the stroke,and the pathological change of which are respectively closely related to endothelial function activation,renin-angiotensin-aldosterone system（RAAS）and sympathetic overactivity at the early stage of clinic.E-selectin（CD62E+）,angiotensin Ⅱ（Ang Ⅱ）and copeptin are respectively treated as the bio-markers of endothelial function activation,RAAS activity and sympathetic nerve activity.However,there are few studies to explore whether the serum levels of CD62E+,Ang Ⅱ and copeptin are changed or not for patients with insomnia.Objective The purpose is to investigate two points for patients with CID:（1）whether the serum levels of CD62E+,Ang Ⅱ,and copeptin is changed or not;（2）whether these bio-markers are associated with the subjective and objective sleep quality or not.Method A total of eighty-six subjects were included in the study which consist of fifty-four patients with CID and thirty-two good sleepers（GS）.It made use of Pittsburgh Sleep Quality Index（PSQI）,Pre-Sleep Arousal Scale（PSAS）,17 Hamilton Depression Scale（HAMD-17）and polysomnography（PSG）to evaluate the subjective and objective sleep quality and neuropsychological function for these subjects.It could be obtained some indicators through analyzing PSG images,which included:（1）sleep process:total sleep time,sleep onset latency,sleep efficiency,wake after sleep onset,number of arousals,and arousal index;（2）Sleep stage:N1,N2,N3 in NREM accounted for the percentage of total sleep time（N1%,N2%,N3%）and REM accounted for the percentage of total sleep time（REM%）;（3）Apnea-hypopnea index（AHI）.It made use of ELISA to measure the serum levels of serum CD62E+,Ang Ⅱ and copeptin.Results There was no significant difference in age and gender between CID group and GS group（P>0.05）.PSQI,PSAS and HAMD-17 scores in the CID group were significantly higher than those in the GS group（P<0.001）.The serum levels of CD62E+,Ang Ⅱ and copeptin in the CID group were significantly higher than those in the GS group（P<0.05）.In the CID group,after controlling for sex,age,depression,and AHI,the partial correlation analysis indicated that serum CD62E+and Ang Ⅱ had no significant correlation with global PSQI scores（P<0.05）,and serum CD62E+was positively correlated with PSAS scores（r=0.300,P=0.034）.Serum copeptin was positively correlated with global PSQI scores（r=0.285,P=0.045）and PSAS scores（r=0.376,P=0.007）.As for objective sleep parameters,CD62E+was negatively correlated total sleep time（r=-0.509,P<0.001）and sleep efficiency（r=-0.556,P<0.001）,and positively correlated with wake after sleep onset（r=0.554,P<0.001）.Serum Ang Ⅱ was negatively correlated with sleep onset latency（r=-0.346,P=0.014）.Serum copeptin was positively correlated with sleep onset latency（r=0.370,P=0.008）,number of arousals（r=0.572,P<0.001）,arousal index（r=0.392,P<0.005）and N1%（r=0.354,P=0.012）,and negatively correlated with N2%（r=-0.386,P=0.006）.In addition,we found a positive correlation between serum CD62E+and Ang Ⅱ levels（r=0.462,P=0.001）.The results of Principal component analysis show that the PSG parameters of sleep duration（total sleep time,sleep efficiency,wake after sleep onset and arousal index）and CD62E+loaded highly on factor 1.The PSG parameters of sleep fragmentation（number of arousals,arousal index,N1%and N2%）and copeptin loaded on factor 2.Age,N1%,REM%and AHI loaded on factor 3;HAMD-17 score and N3%loaded on factor 4;and levels of CD62E+and Ang Ⅱ loaded on factor 5.Conclusion Patients with CID exhibit endothelial activation,over-activated renin-angiotensin system and increased sympathetic excitability,as indicated by increased serum levels of CD62E+,angiotensin Ⅱ and copeptin,with linking to poor sleep quality. |
PDF Full Text Request