Correlation between serum levels of testosterone and estradiol and mild cognitive #br#
HAN Qingyu1, ZHAO Lin1, LI Juan1, CHEN Xiaopeng2, QIAN Wei1
(1. Department of OtolaryngologyHead and Neck Surgery, 2. Department of Neurology, Affiliated People′s Hospital of Jiangsu University, Zhenjiang Jiangsu 212002, China)
Abstract:Objective: To investigate serum testosterone and estradiol levels in male patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and their association with mild cognitive impairment (MCI). Methods: A total of 168 male patients with OSAHS were included and divided into OSAHS with MCI group (85 cases) and OSAHS without MCI group (83 cases). The basic information, sleep breathing monitoring indicators and sex hormone levels between the two groups were compared. The influencing factors of male OSAHS patients with MCI were evaluated by Logistic regression, and ROC curve was drawn to evaluate the corresponding diagnostic values. Pearson correlation analysis was used to evaluate the correlation between serum levels of testosterone and estradiol and serum levels of IL6 and MMP9. Results: There were no significant differences in age, hypertension, diabetes, body mass index (BMI), apnea hypopnea index (AHI), minimum oxygen saturation at night (LSaO2), oxygen drop index and arousal index between the two groups (P>0.05). There were significant differences in smoking and the percentage of SaO2<90% in the total monitoring time (T90) between the two groups (P<0.05). The serum levels of testosterone, estradiol and prolactin in male OSAHS with MCI group were significantly lower than those in male OSAHS without MCI group (P<0.01). Logistic regression analysis showed that T90 was an independent risk factor for male OSAHS with MCI (P<0.01), and serum testosterone and estradiol levels were independent protective factors for OSAHS with MCI in male patients (P<0.01). The area under ROC curve of combined testosterone and estradiol was 0.806, and the sensitivity and specificity were 83.53% and 79.27%, respectively. There was a negative correlation between serum testosterone level and serum IL6 and MMP9 levels (r=-0.683, -0.607, P<0.05); and serum estradiol level was negatively correlated with serum IL6 and MMP9 levels (r=-0.662, -0.615, P<0.05). Conclusion: Decreased serum testosterone and estradiol levels were associated with MCI in male OSAHS patients.
[1]De Luca D, van Kaam AH, Tingay DG, et al. The Montreux definition of neonatal ARDS: biological and clinical background behind the description of a new entity[J]. Lancet Respir Med, 2017, 5(8): 657-666.
[2]江苏省新生儿ARDS研究协作组. 基于“柏林定义”的新生儿急性呼吸窘迫综合征临床流行病学调查研究[J]. 中华新生儿科杂志, 2018, 33(5): 339-343.
[3]张永芳, 于新桥, 廖建华, 等. 鄂西南地区新生儿急性呼吸窘迫综合征临床流行病学调查[J]. 中国当代儿科杂志, 2020, 22(9): 942-947.
[4]Kidman AM, Manley BJ, Boland RA, et al. Predictors and outcomes of extubation failure in extremely preterm infants[J]. J Paediatr Child Health, 2021, 57(6): 913-919.
[5]Hunt KA, Hunt I, Ali K, et al. Prediction of extubation success using the diaphragmatic electromyograph results in ventilated neonates[J]. J Perinat Med, 2020, 48(6): 609-614.
[6]刘笑艺, 童笑梅. 早产儿有创机械通气初次撤机失败相关危险因素分析[J]. 中国当代儿科杂志, 2021, 23(6): 569-574.
[7]Nascimento MS, Rebello CM, Vale LAPA, et al. Spontaneous breathing test in the prediction of extubation failure in the pediatric population[J]. Einstein (Sao Paulo), 2017, 15(2): 162-166.
[8]苏小燕, 何颜霞. 小儿呼吸机撤机的影响因素及撤机指标预测价值分析[J]. 中华儿科杂志, 2014, 52(10): 783-787.
[9]Siddall E, Khatri M, Radhakrishnan J. Capillary leak syndrome: etiologies, pathophysiology, and management[J]. Kidney Int, 2017, 92(1): 37-46.
[10]许峰, 王荃, 钱素云. 2015年版“儿童急性呼吸窘迫综合征: 儿童急性肺损伤会议共识推荐”指南解读[J]. 中华儿科杂志, 2016, 54(5): 323-326.
[11]郭静雨, 陈龙, 史源. 基于“蒙特勒标准”的新生儿急性呼吸窘迫综合征的单中心回顾性研究[J]. 中国当代儿科杂志, 2020, 22(12): 1267-1272.
[12]Chawla S, Natarajan G, Shankaran S, et al. Markers of successful extubation in extremely preterm infants, and morbidity after failed extubation[J]. J Pediatr, 2017, 189: 113-119.
[13]Mehrabadi A, Lisonkova S, Joseph KS. Heterogeneity of respiratory distress syndrome: risk factors and morbidity associated with early and late gestation disease[J]. BMC Pregnancy Childbirth, 2016, 16(1): 281.
[14]Deliloglu B, Tuzun F, Cengiz MM, et al. Endotracheal surfactant combined with budesonide for neonatal ARDS[J]. Front Pediatr, 2020, 8: 210.
[15]Joseph KS. The natural history of pregnancy: diseases of early and late gestation[J]. Br J Obstet Gynaecol, 2011, 118(13): 1617-1629.
[16]盛丽娟, 赵海燕, 丁悦, 等. 危重症新生儿毛细血管渗漏综合征的临床流行病学调查[J]. 中国小儿急救医学, 2017, 24(1): 65-68.
[17]Joshi S, Kotecha S. Lung growth and development[J]. Early Hum Dev, 2007, 83(12): 789-794.