Correlation Analysis Of TLR4,TNF-α And Obstructive Sleep Apnea

Objective:In this study,we detected the expression levels of TLR4 and TNF-α in peripheral blood serum of patients with obstructive sleep apnea(OSA)of different severity.Analyze the correlation between TLR4,TNF-α and AHI,BIM,age,longest apnea time at night,lowest oxygen saturation at night(LSaO2),Mean oxygen saturation at night(MSaO2),excessive daytime sleepiness(ESD),sleep quality at night.Clarify the correlation between TLR4,TNF-α and OSA.By analyzing the correlation between the expression level of TLR4 and TNF-α,for provide a new method for OSA and severity evaluation.Methods:Select patients with high-risk factors or related clinical symptoms of OSA who were treated in the outpatient department and inpatient department of the Second Affiliated Hospital of Kunming Medical University from April 2018 to October 2019,and parallel polysomnography(PSG)and questionnaire,and exclude unqualified persons.Finally,12 cases were selected as the normal control group,11 cases in the moderate group and 21 cases in the severe OSA group-were selected.Because the mild OSA group is too few,this study was not included.First,collecting the information of related case including gender,age,height,weight,ESS,PSQI and so on.Second,record the PSG related data,including AHI,the longest apnea time,LSaO2%,MSaO2%.Then,drawned the fasting blood,centrifuged the serum,and determined the expression levels of TLR4 and TNF-α in the serum by ELISA.Compare and analyze the differences of TLR4,TNF-α expression levels,ESS,PSQI of each group,analyze the correlation of TLR4,TNF-α expression levels with PSG-related indicators,ESS,PSQI,and assess whether they are related to the severity of OSA.Results:1.General data analysis of each group.There were no significant differences in age.BMI and PSQI among the groups.There were significant differences in AHI,TLR4,LSaO2,MSaO2,Longest Apean Time and ESS among the groups.Moderate,severe OSA group AHI was significantly higher than normal group(P<0.001),severe OSA group AHI was significantly higher than moderate OSA group(P<0.001).Moderate,severe OSA group LSaO2 was significantly lower than normal group(P<0.05).Severe OSA group MSaO2 was significantly lower than normal group(P<0.005).The longest apean time in severe OSA group was significantly higher than normal group,moderate OSA group(P<0.05).The ess in Moderate,severe OSA group was significantly higher than normal group(P<0.05).2.Correlation between the expression levels of TLR4、TNF-α and AHI;the expression levels of TLR4、TNF-α in the serum of each group.(1).Compared with NC group,with the severity of OSA worsened,the serum TLR4 expression level of each group showed an upward trend,and there weresignificant differences between the groups(F=9.019,P=0.001<0.05).The expression level of serum TLR4 in the moderate OSA group and the severe OSA group(P<0.05)was significantly higher than that in NC group.The difference bentween the moderate OSA group and the severe OSA group was not statistically significant(P>0.05).(2)Compared with NC group,with the severity of OSA worsened,the serum TNF-α expression level of each group showed an upward trend,and there were significant differences between the groups(F=5.68,P<0.05).The expression level of serum TNF-α in the moderate OSA group(P<0.05)and the severe OSA group(P<0.05)was significantly higher than that of NC group;the difference between the severe OSA group and the moderate OSA group was not statistically significant(P>0.05).(3)Serum TLR4 expression level was significantly positively correlated with AHI(r=0.423,P<0.05);Serum TNF-αexpression level was significantly positively correlated with AHI(r=0.422,P<0.05).3.Correlation analysis of TNF-α expression level and TLR4 expression level.The serum TNF-α expression level was significantly positively correlated with TLR4 expression level(r=0.762,P<0.001).4.Correlation analysis of sleeping breathing parameters and TLR4 expression in each group.(1)The expression of TLR4 and TNF-α was significantly positively correlated with the longest asphyxia time at night(r=0.353,P<0.05;r=0.31 7,P<0.05);(2)The expression of TLR4 and TNF-αwas significantly negatively correlated with MSaO2(r=-0.440;P<0.05;r=-0.3459,P<0.05);(3)The expression of TLR4 and TNF-α was negatively correlated with LSaO2,but P>0.05。when LSaO2<85%,the expression level of TLR4 and TNF-α of OSA patients increased significantly(P<0.05).5.Analysis of ESD(ESS(?)9)in each group,and correlation between ESD and TLR4,TNF-α.(1)Compared with NC group,as the severity of OSA worsened,the ESD of OSA patients gradually increased,and the difference between the groups was statistically significant(P<0.05).The difference in ESD between moderate OSA、severe OSA group(P<0.05)and NC group was statistically significant.There was no significant difference in sleepiness between the moderate and severe OSA groups(P=0.815>0.05).(2)Compared with people without ESD symptoms,patients with ESD had significantly higher serum TLR4 and TNF-α expression level,the difference was statistically significant(P<0.05).6.Correlation between sleep disorders and TLR4,TNF-α.(1)Compared with NC group,there was no statistically significant difference in the presence of sleep disorders in the moderate and severe OSA groups.(2)Compared with people without symptoms of sleep disorders,there was no statistically significant difference in the expression level of TLR4 and TNF-α in patients with sleep disorder(P>0.05).Conclusion(s):1.Compared with NC group,with the severity of OSA worsene,the expression levels of TLR4 and TNF-α in the patient’s serum increased significantly.2.The expression level of TLR4 and TNF-α was significantly positively correlated with AHI and the longest apean time,negatively correlated with MSaO2,and not significantly correlated with LSaO2、age and BMI。3.when LSaO2<85%,the expression level of TLR4 and TNF-α of OSA patients increased significantly.4.Compared with NC group,the moderate and severe OSA had significantly increased symptoms of ESD.Compared with those without ESD,the expression level of serum TLR4 and TNF-α was significantly increased in people with ESD.5.Compared with NC group,there was no significant increase in the presence of sleep disorders in patients with moderate and severe OSA;compared with the population without sleep disorders,the expression level of serum TLR4 and TNF-α in the patients with sleep disorders was not significantly increased.