ABSTRACT
Objective To investigate the significance of changes in serum uric acid levels in elderly patients with obstructive sleep apnea hyponea syndrome (OSAHS).Methods The study recruited elderly patients aged 60 years and over undergoing polysomnography (PSG) at the Center for Diagnosis and Treatment of Sleep Disorders of our hospital from January 2012 to December 2014.According to the diagnostic criteria established by the Group of Sleep and Breathing Disorders,Respiratory Diseases Branch,Chinese Medical Association (2011),patients were divided into the simple snoring group,the mild OSAHS group,the moderate OSAHS group and the severe OSAHS group.Levels of serum uric acid,blood glucose,blood lipids and high-sensitive C-reactive protein (hsCRP) were compared between all groups after adjusting for age,gender and underlying diseases.Independent risk factors associated with serum uric acid were analyzed using Spearman' s rank correlation and stepwise multivariate analysis.Results A total of 129 elderly subjects including 100 males and 29 females,with a mean age of (63.6±2.25) years,were enrolled.Of these subjects,23 were grouped as simple snoring,24 as mild OSAHS,39 as moderate OSAHS and 43 as severe OSAHS.Serum uric acid and hs-CRP levels were increased in the severe OSAHS group as compared with the simple snoring group (both P＜0.05).Spearman's rank correlation analysis showed that the apnea-hypopnea index (AHI) and the oxygen desaturation index (ODD were positively correlated with the serum uric acid level (r =0.251 and 0.210,P =0.004 and 0.018,respectively).Stepwise multivariate analysis showed that,with serum uric acid level as the dependent variable,AHI was an independent risk factor for increased serum uric acid levels (β=0.354,P =0.000).Conclusions Serum uric acid levels are elevated in elderly patients with severe OSAHS,and AHI is an independent risk factor for the increased serum uric acid levels.
ABSTRACT
Objective To investigate the effect of β-lactam antibiotics on the false positive rate of the serum Aspergillus galactomannan (GM) assay in patients with lung diseases.Methods We selectively recruited 77 lung disease patients who did not meet the diagnostic criteria of invasive pulmonary Aspergillosis (IPA) and received different β-lactam antibiotics,while 41 patients without IPA who did not receive any antibiotic treatment were recruited as the control group.Serum samples for GM detection were collected from all participants.The rate of false-positive Aspergillus galactomannan was compared between the two groups.Results False-positive serum results were found in patients who received piperacillin-tazobactam (30.8％ or 8/26) and cefoperazone sulbactamand (27.8％ or 5/18).The rate of false-positive Aspergillus galactomannan in patients who receive β-lactam antibiotics were significantly higher than that in the control group (24.7％ or 19/77vs.7.3％ or 3/41,x2 =5.315,P=0.025).Taking false-positive serum Aspergillus galactomannan as the dependent variable and β-lactam antibiotic treatment as the independent variable,univariate logistic regression analysis showed that the rate of false-positive Aspergillus galactomannan in patients who received β-lactam antibiotics were 4.149 times more than that in the control group (OR=4.149,P=0.030).Conclusions The administration of β-lactam antibiotics may increase the occurrence of false-positive serum Aspergillus galactomannan,and physicians should be aware of this possible interference.
ABSTRACT
Objective To investigate the change of serum cystatin C (CC) level and its clinical significance in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS),and to evaluate the diagnostic value of serum CC for renal impairment in elderly OSAHS patients.Methods Elderly snoring subjects (age ≥60 years) undergoing sleep apnea monitoring in our sleep laboratory were recruited.Patients were divided into simple snoring group,mild OSAHS group,moderate OSAHS group and severe OSAHS group according to the diagnostic criteria of American academy of sleep medicine.Anthropometric characteristics,lipid profiles,blood glucose,creatinine,estimated glomerular filtration rate (eGFR) and serum CC were compared between groups after age,gender and basic diseases were adjusted.The independent risk factors associated with serum CC were analyzed by Spearman's rank correlation and stepwise linear regression.Results Totally 89 elderly patients [70males and 29 females,aged (68.4±6.3) years in average] were collected.21 subjects were grouped as simple snoring,14 subjects as mild OSAHS,21 subjects as moderate OSAHS and 33 subjects as severe OSAHS.There were no differences in age,gender,basic diseases (hypertension and diabetes),lipid profiles,creatinine and eGFR among groups.The levels of body mass index,systolic blood pressure,diastolic blood pressure and serum CC were higher in severe OSAHS group than in simple snoring group [(28.3±3.9) vs.(24.6±5.9),(136.55±16.14) mm Hgvs.(122.43±16.64) mm Hg,(89.18±11.92) mm Hgvs.(78.10±9.55) mm Hg,(0.95±0.22) mg/L vs.(0.76±0.13)mg/L,respectively,all P＜0.05].Serum CC was significantly correlated with apnea hypopnea index (AHI),oxygen desaturation index,creatinine,eGFR,high sensitive C reactive protein (r=0.397,0.347,0.275,－0.354,0.254 respectively,all P％0.05).Regression analysis showed that AHI was an independent factor for serum CC (β=0.449,P＜ 0.001).Conclusions Serum CC level is increased in elderly patients with severe OSAHS.AHI is an independent factor for the increase of serum CC.Serum CC can be as an index for the early impairment of renal function in patients with OSAHS.