男性輪值勞工睡眠呼吸障礙嚴重度與血中自由基及抗氧化能力相關性探討

The relationship between the severity of sleeping disordered breathing and the blood levels of free radical and antioxidant potential male rotating shift workers

曾寶慧(Bao-Hui Tzang)

指導教授 ： 曾博修 ； 周芬碧 ； 丁化

中山醫學大學/醫學院/生化暨生物科技研究所/碩士(2009年)

摘要

根據統計在台灣約有1.7％民眾或成人罹患睡眠呼吸障礙之呼吸中止症，進而影響睡眠品質。而輪值工作更加重睡眠品質的惡化。研究顯示，睡眠呼吸中止症引起間歇性組織缺氧，而導致氧化壓力的上升。本研究目的在於探討睡眠呼吸障礙嚴重程度與全血中自由基與血清中總抗氧化能力、血液生化值及代謝性症候群之相關性探討。196位男性輪值勞工在經由一夜的多頻道睡眠生理檢查（polysomnography, PSG），並於隔日清晨採取靜脈血液標本後由超微弱化學發光分析法，同時偵測體內全血中的超氧陰離子（superoxide anion）與羥基自由基（hydroxyl radical）及人體血清中抗氧能力。並進行生化分析檢測，以便進一步分析變數間的相關性變化。結果：可發現總抗化能力（Total radical-trapping antioxidant parameter ,TRAP）與睡眠呼吸障礙嚴重度增加成正相關。。然而High Sensitive CRP 會與Superoxide anion radicals及睡眠呼吸障礙指數（Respiratory Disturbance Index , RDI）RDI值在經由可能干擾因子年齡與身體質量指數（Body Mass Index， BMI）校正之後亦成正相關。而總抗氧化能力會與Hydroxyl Radical成負相關。間接說明睡眠呼吸障礙會影響發炎反應的產生外，更影響自由基Hydroxl Radical形成。總抗氧化能力TRAP在經由校正干擾因子年齡與BMI後，與RDI及尿酸呈正相關。而隨著RDI指數越高，TRAP及尿酸相對也升高。另外發現，身體質量數與自由基Superoxide anion radicals、Hydroxyl radical及TTRAP都有正相關。而睡眠呼吸障礙嚴重度指數（RDI值）與代謝症候群（MS）、有無抽菸分組均無顯著關聯。由生活型態調查發現極少數（2-3位）受試者有規律運動習慣，54%有抽菸習慣而其工作均為長期輪班型態，本研究結果證實睡眠呼吸障礙嚴重度確實與體內自由基及總抗氧化能力、HSCRP及代謝性生化如尿酸具有相關性。可印證睡眠呼吸障礙嚴重度與氧化性壓力是具有相關性的，其所累積的氧化壓力可能對心血管疾病造成傷害，而同時卻也可能引起抗氧化能力的增強的。至於相關的引發機制，未來仍需進一步探討。

關鍵字

輪值勞工 ； 睡眠呼吸障礙 ； 自由基 ； 抗氧化能力

並列摘要

According to statistics， about 1.7 percent of Taiwan adults have been suffering from Sleep Apnea Syndrome of sleep disordered breathing that impact on sleeping quality, especially for the people who work on night shift are getting worse. Some studies have shown that sleep apnea syndrome could induce intermittent hypoxia, and cause oxidative stress increasing. The purposes of this study are trying to understand the relationship between severity of sleeping-disorder, whole blood free radicals and total antioxidant capacity in serum. Sample consists of 196 male worker who have engaged in rotation work, kept a check on polysomnography ( PSG ) over night, and we use ultra-weak chemiluminescence analysis with the sample of venous blood in the next morning to detect superoxide anion, hydroxyl radical and serum antioxidant capacity of whole blood at the same time. Also, biochemical analysis and inspection of blood are held for further examination of the correlation between variables change. Results: The positive correlation of relationship between Total radical-trapping antioxidant parameter(TRAP)and the increasing severity of sleep-disordered breathing could be found in those samples. Nevertheless, with the adjustments on possible confounding factors of age and BMI, the relationship between High Sensitive CRP, Superoxide anion radicals and the Respiratory Disturbance Index (RDI) values were positively correlated too, while total antioxidant capacity will be negative correlating with Hydroxyl Radical. Those have indicated indirectly that the sleep-disordered breathing not only affect the level of inflammation, but also affect the formation of free radicals Hydroxyl Radical. After adjusting possible confounding factors of age and BMI, TRAP revealed positive correlation with both RDI and uric acid, and both TRAP and uric acid are rising following RDI. Besides, we found that the reaction between the index of body mass, the superoxide anion radicals, hydroxyl radical and total antioxidant capacity are positively correlated. However, there were no significant cross-correlation between RDI value, metabolic syndrome (MS) and smoking. Mention to the life style, few experimental subjects（2-3 persons）have regular exercise and 54% of samples have smoked, and those are engaged in long-term rotation work. We have confirmed that the severity of sleep-disordered breathing is positive correlated to free radicals, TRAP, HSCRP and metabolic rate of biochemical action, eg uric acid in this study, and it would be proved the severity of sleep-disordered breathing is correlated to oxidative stress that will be harmful for cardiovascular disease. Furthermore, it would increase the antioxidative capability simultaneously. So far the associate mechanisms are needed to be further studied.

並列關鍵字

rotating shift workers ； sleeping disordered breathing ； free radical ； antioxidant potential

參考文獻

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