Objective To investigate the effect of angiopoietin-like protein 3 (ANGPTL3) on lipid metabolism in patients with obstructive sleep apnea (OSA). Methods A total of 59 OSA patients and 20 healthy controls from the First Affiliated Hospital of Zhengzhou University between May 2023 and February 2024 were included in the study. All participants underwent overnight polysomnography (PSG). Based on the apnea-hypopnea index (AHI), the OSA patients were divided into a mild group and a moderate-to-severe group. Morning blood samples were collected after an 8-hour fast to measure lipid profiles and ANGPTL3 levels. Statistical analyses were performed using SPSS 25.0 software. Results The levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and ANGPTL3 were significantly higher, while high-density lipoprotein cholesterol (HDL-C) was significantly lower in the OSA group compared with the control group (P<0.05). ANGPTL3 level was higher in the moderate-to-severe OSA group than that in the mild OSA group and the control group, and higher in the mild OSA group than that in the control group (P<0.05). In the severe hypoxemia group, ANGPTL3 level was significantly higher than that in the mild-to-moderate hypoxemia group (P<0.05). The ANGPTL3 level was also significantly higher in the hyperlipidemia group compared wiht the non-hyperlipidemia group (P<0.05). In the OSA group, ANGPTL3 was positively correlated with TC, TG, percentage of cumulative time with oxygen saturation below 90% in total sleep time (T90) and oxygen desaturation index (ODI), and negatively correlated with lowest arterial oxygen saturation (LSaO2) and mean arterial oxygen saturation (MSaO2). After adjusting for relevant confounding factors, logistic regression analysis indicated that ANGPTL3 might be a potential independent risk factor for OSA, with an odds ratio of 1.021 (95%CI 1.002 - 1.040). Conclusions The level of ANGPTL3 is elevated in OSA patients. The elevation of blood lipid levels in OSA patients may be associated with chronic intermittent hypoxia-induced regulation of ANGPTL3 levels.
Objective To investigate the value of serum angiopoietin like protein 4 (ANGPTL-4), growth differentiation factor 15 (GDF-15) and fibroblast growth factor 21 (FGF-21) in evaluating the condition and predicting the prognosis of patients with acute respiratory distress syndrome (ARDS). Methods The clinical data of 147 patients with ARDS admitted in our hospital from January 2019 to December 2021 were collected. The levels of serum ANGPTL-4, GDF-15 and FGF-21 in the ARDS patients on the day of admission were detected. According to the oxygenation index(OI), the ARDS patients were divided into a mild group with 38 cases (200 mm Hg <OI≤300 mm Hg), a moderate group with 63 cases (100 mm Hg <OI≤200 mm Hg) and a severe group with 46 cases (OI≤100 mm Hg). According to the survival within 28 days after entering the intensive care unit, the ARDS patients were divided into a survival group with 90 cases and a death group with 57 cases. Multivariate logistic regression analysis was used to analyze the risk factors of death in the patients with ARDS. Receiver operator characteristic curve were drawn to analyze the value of serum ANGPTL-4, GDF-15 and FGF-21 levels in predicting the prognosis of ARDS patients. Pearson correlation was used to analyze the correlation between serum ANGPTL-4, GDF-15 and FGF-21 levels. Results The levels of serum ANGPTL-4, GDF-15 and FGF-21 in the death group were significantly higher than those in the survival group (all P<0.001). The levels of serum ANGPTL-4, GDF-15 and FGF-21 in the severe group were significantly higher than those in the mild group and the moderate group (all P<0.001). Multivariate logistic regression analysis showed that the levels of OI (OR=2.416, 95%CI 1.615 - 5.470), APACHEⅡ score (OR=2.795, 95%CI 1.973 - 6.874), SOFA score (OR=1.692, 95%CI 1.170 - 3.105), ANGPTL-4 (OR=1.951, 95%CI 1.360 - 4.208), GDF-15 (OR=2.583, 95%CI 1.804 - 6.195) and FGF-21 (OR=3.116, 95%CI 2.513 - 9.307) were the risk factors of death in patients with ARDS (P<0.05). The area under the ROC curve of combination of ANGPTL-4, GDF-15 and FGF-21 was the highest (0.953, 95%CI 0.892 - 0.998) for prediction the death of ARDS patients, with a sensitivity of 98.0% and specificity of 87.3%. Correlation analysis showed that serum ANGPTL-4 level was positively correlated with GDF-15 and FGF-21 in the ARDS patients (P<0.001). Conclusions The elevated levels of serum ANGPTL-4, GDF-15 and FGF-21 are related to the severity and death of ARDS patients. The combined detection of serum ANGPTL-4, GDF-15 and FGF-21 is helpful to predict the prognosis of ARDS patients.
Objective To investigate the protective effects of 6-O-desulfated heparin (6-DeH) on lung injury in septic mice by inhibiting the degradation of endothelial glycocalyx degradation. Methods BALB/c mice were divided into a sham group, a sepsis group, and a sepsis+6-DeH group. Cecal perforation surgery was used to establish sepsis model. After modeling, the sepsis+6-DeH group was given 2 mL of 5 g/L 6-DeH solution for nebulized inhalation, while the sham group and the sepsis group were given 2 mL of normal saline for nebulized inhalation, once every other day. Lung wet/dry weight ratio, protein concentration in bronchoalveolar lavage fluid (BALF), pathological changes of lung tissue, protein expression levels of CD31, thromboxomodulin (TM), hyaluronic acid (HA), heparan sulfate (HS), syndecan-1, glypican, angiopoietin 1 (Ang1), angiopoietin 2 (Ang2), Tie2 in lung tissue, co-localization of CD31 and syndecan-1 were detected at 14 days of intervention. Results Lung wet/dry weight ratio, protein concentration in BALF, protein expression level of Ang2 in lung tissue of the sepsis group were all significantly higher than those of the sham group, while protein expression levels of CD31, TM, HA, HS, syndecan-1, glypican, Ang1 and Tie2 in lung tissue were significantly lower than those of the sham group (all P<0.05). Lung wet/dry weight ratio, protein concentration in BALF, protein expression level of Ang2 in lung tissue of the sepsis+6-DeH group were all lower than those of the sepsis group, while protein expression levels of CD31, TM, HA, HS, syndecan-1, glypican, Ang1 and Tie2 in lung tissue were all higher than those of the sepsis group (all P<0.05). Immunofluorescence revealed co-localization of CD31 and syndecan-1 in lung tissue. Conclusions 6-DeH alleviates lung injury and inhibits degradation of endothelial glycocalyx in pulmonary blood vessels in septic mice. This effect is related to the regulation of the Ang/Tie2 pathway.