Periostin and TNF-α expression levels in peripheral blood of patients with acute cerebral infarction combined with obstructive sleep apnea syndrome and their predictive value for clinical prognosis

Abstract

Objective To detect the expression levels of periostin and tumour necrosis factor-α (TNF-α) in patients with acute cerebral infarction (ACI) combined with obstructive sleep apnea syndrome (OSAS) and to investigate their predictive value for clinical prognosis. Methods In this case‒control study, serum periostin and TNF-α levels were measured using ELISA, and patients were scored on the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Receiver operating characteristic curve(ROC) were generated to analyse the effect of peripheral blood periostin and TNF-α levels on poor prognosis. Results NIHSS score, mRS score and peripheral blood periostin and TNF-α levels were higher in the observation group than in the control group (P < 0.001); serum periostin and TNF-α levels were positively correlated with the NIHSS score and mRS score (P < 0.001). Serum periostin and TNF-α levels were higher in patients with a poor prognosis than in those with a favourable prognosis (P < 0.001); the area under curve (AUC) values for the diagnosis of poor prognosis based on TNF-α, periostin or both factors were 0.868 (95% CI: 0.781–0.954), 0.834 (95% CI: 0.734–0.934), and 0.875 (95% CI: 0.792 ~ 0.958), with sensitivities of 0.654, 0.846, and 0.654 and specificities of 0.944, 0.750, and 0.917, respectively. Conclusion Patients with ACI combined with OSAS have elevated peripheral blood periostin and TNF-α levels, and the combination of these two factors has high predictive value for poor prognosis.

Intermittent hypoxia: linkage between OSAS and epilepsy

“…TNF-α leads to activation of the NF-κB pathway and further activates nitric oxide synthase, cyclooxygenase and other receptors, participating in sleep regulation (Ramesh et al, 2012). Elevated levels of TNF-α were observed in OSAS patients, which were demonstrated to be associated with poor outcomes (Xin et al, 2022). In addition, it was noted by Olszewska E et al that high levels of TNF-α were declined in OSAS patients after surgery (Olszewska et al, 2022).…”