Sains Malaysiana 49(7)(2020): 1713-1718

http://dx.doi.org/10.17576/jsm-2020-4907-21

Role of Serum Asymmetric Dimethylarginine Level in Cardiovascular Diseases Early Prognostic in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

(Peranan Tahap Serum Asimetri Dimetilarginina pada Pesakit Prognostik Awal Penyakit Kardiovaskular dengan Sindrom Apnea-Hipopnea Tidur Obstruktif)

JINPING WANG¹*, LIJIE YUAN², HAIXIANG ZHANG³ & YONGGANG YUN¹

¹Department of ENT, Shaanxi Provincial People’s Hospital, Xi’an 710068, China

²Department of Medical Office Infection Management, Shaanxi Provincial People’s Hospital, Xi’an 710068, China

³Central Laboratory of Shaanxi Provincial People’s Hospital, Xi’an 710068, China

Diserahkan: 24 Disember 2019/Diterima: 22 Mac 2020

Abstract

The purpose of this paper was to investigate the role of serum asymmetric dimethylarginine (ADMA) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and identify its clinical significance in OSAHS related cardiovascular diseases. A total of 75 patients with OSAHS were enrolled and divided into mild (n=25), moderate (n=27), and severe group (n=23) according to their apnea hypopnea index (AHI) and minimal oxygen saturation (SaO_{2 min}), respectively. Thirty healthy individuals were enrolled as normal control. Serum ADMA was measured with enzyme-linked immunosorbent assay (ELISA). Nitric oxide (NO) level was assayed with colorimetric method. Nasal continuous positive airway pressure (nCPAP) treatment was performed to the patients, and the follow up lasted for 2 months. Serum ADMA level increased with the severity of patients. Serum NO level decreased with severity of patients. A negative correlation was noticed between serum NO and mean SaO₂ (SaO_{2 mean}) and minimal SaO₂ (SaO_{2 min}). Serum ADMA was positively correlated with AHI, tSaO₂<90%, and morbidity of cardiovascular diseases. After nCPAP therapy, the serum ADMA level was remarkably decreased and NO was remarkably increased in patients with OSAHS. Serum ADMA may be correlated with OSAHS and OSAHS related cardiovascular diseases. Reducing the plasma ADMA level by nCPAP therapy can reduce the morbidity of OSAHS-related cardiovascular diseases.

Keywords: Asymmetric dimethylarginine; nasal continuous positive airway pressure; nitric oxide; obstructive sleep apnea-hypopnea syndrome; SaO₂

ABSTRAK

Kajian ini dijalankan untuk mengkaji peranan serum asimetri dimetilarginin (ADMA) pada pesakit dengan sindrom apnea-hipopnea tidur obstruktif (OSAHS) dan mengenal pasti keertian klinikal dalam penyakit kardiovaskular yang berkaitan dengan OSAHS. Seramai 75 pesakit OSAHS telah didaftarkan dan dibahagikan kepada kumpulan ringan (n=25), sederhana (n=27) dan kumpulan teruk (n=23) mengikut indeks apnea hipopnea (AHI) dan ketepuan oksigen minimum (SaO_{2 min}), masing-masing. Tiga puluh individu yang sihat didaftarkan sebagai kawalan normal. Serum ADMA diukur dengan asai imunoserapan terangkai enzim (ELISA). Tahap oksida nitrat (NO) diuji dengan kaedah kolorimetri. Rawatan tekanan salur udara positif berterusan nasal (nCPAP) dijalankan pada pesakit, dan disusulkan berlangsung selama 2 bulan. Tahap ADMA serum meningkat dengan tahap keterukan pesakit. Tahap NO serum menurun dengan tahap keterukan pesakit. Hubungan negatif diperhatikan antara serum NO dan min SaO₂ (SaO_{2 mean}) dan minimum SaO₂ (SaO_{2 min}). Serum ADMA berkorelasi positif dengan AHI, tSaO₂<90%, dan morbiditi penyakit kardiovaskular. Selepas terapi nCPAP, tahap ADMA serum menurun dan NO meningkat pada pesakit dengan OSAHS. ADMA serum mungkin berkorelasi dengan penyakit kardiovaskular yang berkaitan dengan OSAHS dan OSAHS. Pengurangan tahap ADMA plasma dengan terapi nCPAP dapat mengurangkan tahap penyakit kardiovaskular yang berkaitan dengan OSAHS.

Kata kunci: Asimetri dimetilarginina; nitrik oksida; SaO₂; sindrom apnea-hipopnea tidur obstruktif; tekanan salur udara positif berterusan nasal

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