ROLE OF MELATONIN RECEPTOR EXPRESSION IN DIAGNOSIS OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

Objective. To determine the diagnostic role of the MTNR1B expression by epitheliocytes of the distal esophagus in predicting obstructive sleep apnea/hypopnea syndrome among patients with gastroesophageal reflux disease.

Materials and methods. 84 patients aged 30—60 including those with gastroesophageal reflux disease (Group 1, n=25), patients with gastroesophageal reflux disease combined with obstructive apnea/hypopnea syndrome (Group 2, n=23), patients with obstructive apnea/hypopnea syndrome (Group 3, n=18) and patients lacking gastroesophageal reflux disease and obstructive sleep apnea/hypopnea syndrome included into the group of comparison (Group 4, n=18) were examined. The melatonin 1В receptors (MTNR1B) expression was evaluated by immunohistochemical method in the distal esophageal mucosa bioptates.

Results. The MTNR1B expression was increased in 52.2% (95% СI: 33.0—70.8) of Group 2 patients and in 4% (95% СI: < 0.01—21.1) of Group 1 patients (P=0.00001). The increased MTNR1B expression was associated with the sleep apnea severity (r=0.50; Р=0.0016). The MTNR1B expression threshold value equal to 0.176 was determined.

Conclusion. The determined level of the melatonin 1В receptors expression by epitheliocytes of the distal esophagus with 91.3% sensitivity and 78.3% specificity can be used to detect patients with gastroesophageal reflux disease requiring polysomnographic examinations.

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Автор(ы): A. A. Karpovich, V. I. Shyshko, S. A. Lyalikov