Study Of Galectin-3 And Sestrin2 And Their Correlation With Cardiac Remodeling In Patients With OSAHS Combined With Type 2 Diabetes Mellitus

Objective: The common mechanism oxidative stress in obstructive sleep apnoea hypoventilation syndrome(OSAHS)and type 2 diabetes mellitus(T2DM)is considered to be a key mechanism of cardiac remodeling.Recent studies have confirmed that galactose lectin-3(Galectin-3,Gal-3)and Sestrin2 are associated with T2DM and OSAHS.They may be involved in T2DM and OSAHS pathogenesis through oxidative stress and thus.The objectives of our study were(1)to explore the changes in Gal-3,Sestrin2 levels and cardiac ultrasound indices in patients with T2DM combined with OSAHS;and(2)to analyze the risk factors for T2DM combined with OSAHS and the assessment of Gal-3 and Sestrin2 levels on cardiac remodeling.Methods: Seventy-seven patients with type 2 diabetes mellitus(55 patients in the combined OSAHS group and 22 patients in the pure type 2 diabetes mellitus group),31 patients in the pure OSAHS group and 47 patients in the control group(neither type 2diabetes mellitus nor OSAHS)who visited the Affiliated Hospital of Yangzhou University for polysomnography monitoring between December 2021 and October 2022 were collected to collect basic information,clinical data,The basic information,clinical data,cardiac ultrasound indexes and serum Gal-3 and Sestrin2(detected by double antibody sandwich enzyme-linked immunosorbent assay)were collected from the four groups.They were statistically analyzed using SPSS26.0.Results: 1.(1)There were no statistical differences in the proportion of smoking,proportion of history of alcohol consumption,age,Cr,and TC in the control group,OSAHS-only group,T2DM-only group,and T2DM combined with OSAHS group(P>0.05);while the proportion of men,history of hypertension,history of hyperlipidemia,BMI,NLR,FBG,TG,HDL-C,LDL-C,AHI,MSa O2,and LSa O2,and ODI were statistically different(P<0.05);(2)cardiac ultrasound indices in the T2DM-only and OSAHS-combined T2DM groups,LVESV,LVEDV,and LVMI were higher in the T2DMcombined OSAHS group than in the T2DM-only group(all P<0.05);LVEF,LADI,and RWT were not significantly different in the two groups.2.Serum Gal-3 levels in the control,OSAHS alone,T2DM alone and T2DM combined with OSAHS groups were OSAHS combined with T2DM > OSAHS alone >T2DM alone > control(P<0.001),and Sestrin2 levels in the T2DM combined with OSAHS group were higher than those in the T2DM alone and control groups(P< 0.05).Sestrin2 and NLR levels were higher in the T2DM combined with OSAHS group than in the OSAHS alone group,but the difference between the groups was not significant.3.Influencing factors and ROC curves in the combined OSAHS group in T2DM:(1)Binary logistic regression analysis,after excluding confounding factors such as BMI,TG,HDL-C,LVMI,LVEDV and LVESV,increased serum Gal-3 levels(OR=1.302,95% CI:1.019-1.664,P=0.035),increased serum Sestrin2(OR=1.904,95%CI:1.129-3.211,P=0.016)were risk factors for combined OSAHS in T2DM.(2)The area under the curve of Gal-3 predicted 0.803(95%CI:0.730-0.876,P<0.001)in T2DM combined with OSAHS population,and the best cut-off value of Gal-3 was 11.62ng/ml(sensitivity72.7%,specificity 78.0%);the area under the curve of Sestrin2 predicted 0.6.0 in T2DM combined with OSAHS population The area under the curve for Sestrin2 was 0.687(95%CI:0.602-0.772,P<0.001)and the best cut-off value for Sestrin2 was 6.705ng/ml(sensitivity 67.3%,specificity 65.0%).4.Correlation analysis showed that Gal-3 was positively correlated with AHI,LVEDV,LVESV,LADI and LVMI,and Sestrin2 was positively correlated with AHI,LADI and LVMI.5.(1)The T2DM combined with OSAHS group was divided into subgroups according to the severity of OSAHS.There was no statistically significant difference between the mild,moderate and severe OSAHS groups in terms of the percentage of personal history,age,gender,BMI,TC,TG,HDL-C,LDL-C,Sestrin2 and NLR(all P >0.05).(2)There were statistically significant differences in AHI,MSa O2,LSa O2 and ODI among the three groups(all P< 0.001).(3)The LADI and LVMI levels were for the severe OSAHS group > mild OSAHS group(P < 0.05).(4)Gal-3 levels were higher in the severe OSAHS group than in the mild OSAHS group and the moderate OSAHS group(P < 0.05).6.Ordinal logistic regression analysis between subgroups: increased serum Gal-3and LVMI were risk factors for sleep apnea severity in T2DM combined with OSAHS.7.AHI was positively correlated with Gal-3,LVMI and LADI,MSa O2 was negatively correlated with LADI and LVMI,and LSa O2 was negatively correlated with Gal-3 and LADI(all P < 0.05).Conclusion: 1.Serum Gal-3 and Sestrin2 levels were increased in patients with T2DM combined with OSAHS,which may suggest combined OSAHS in T2DM population.2.Serum Gal-3 levels increased with increasing severity of sleep apnea in patients with T2DM combined with OSAHS.3.Gal-3 and Sestrin2 were associated with the severity of cardiac remodeling in T2DM combined with OSAHS,and LVMI may be a risk factor for the severity of OSAHS in the T2DM combined with OSAHS population.