血浆半乳糖凝集素-3作为慢性失眠的潜在预测因子及其与慢性偏头痛NLRP3炎性体激活的关系：一项病例对照研究

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-09-01 DOI:10.1016/j.sleep.2025.106793

Wubing Zhou

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引用次数: 0

摘要

背景：慢性失眠（CI）通常与慢性偏头痛（CM）同时发生，神经炎症可能是这种关联的基础。半乳糖凝集素-3是一种促炎介质，与偏头痛和睡眠调节有关，但其在cm相关性失眠中的作用及其与NLRP3炎性体激活的关系尚不清楚。方法对150例CM患者进行病例对照研究，采用ICSD-3标准和匹兹堡睡眠质量指数（PSQI）进行CI状态分类。测量临床特征、心理评估和血浆生物标志物（半乳糖凝集素-3、NLRP3、IL-1β）。逻辑回归、多元线性回归、中介分析和ROC曲线评估相关性和诊断效果。结果与无失眠CM （CM- nci）相比，失眠CM （CM- ci）的Galectin-3（18.69±2.95∶13.41±2.48 ng/mL）、NLRP3（6.72±1.24∶4.02±1.14 ng/mL）、IL-1β（5.39±1.27∶3.71±0.87 pg/mL， P均为0.001）升高。半乳糖凝集素-3独立预测CI（调整后OR = 1.393; 95% CI: 1.153-1.681; P < 0.001）。介导分析表明NLRP3和IL-1β介导了部分作用（分别为41.4%和36.2%）。ROC分析显示，鉴别效果良好（AUC = 0.888；截止值= 15.85 ng/mL；敏感性= 84.0%；特异性= 82.0%）。调整后半乳糖凝集素-3与PSQI、焦虑、抑郁、偏头痛影响和炎症标志物相关（P均为0.001）。结论血浆半乳糖凝集素-3升高与CM患者CI密切相关，具有较好的预测价值。它与NLRP3和IL-1β的关系提示了一个共同的神经炎症途径，突出了半乳糖凝集素-3作为CM患者失眠风险分层和靶向管理的潜在生物标志物。

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Plasma Galectin-3 as a potential predictor of chronic insomnia and its association with NLRP3 inflammasome activation in chronic migraine: A case-control study

Background

Chronic insomnia (CI) commonly co-occurs with chronic migraine (CM), and neuroinflammation may underlie this association. Galectin-3, a pro-inflammatory mediator, has been implicated in migraine and sleep regulation, but its role in CM-related insomnia and its link to NLRP3 inflammasome activation remain unclear.

Methods

We conducted a case-control study of 150 CM patients, categorized by CI status using ICSD-3 criteria and Pittsburgh Sleep Quality Index (PSQI). Clinical features, psychological assessments, and plasma biomarkers (Galectin-3, NLRP3, IL-1β) were measured. Logistic regression, multiple linear regression, mediation analysis, and ROC curves evaluated associations and diagnostic performance.

Results

Compared with CM without insomnia (CM-nCI), CM with insomnia (CM-CI) showed higher Galectin-3 (18.69 ± 2.95 vs. 13.41 ± 2.48 ng/mL), NLRP3 (6.72 ± 1.24 vs. 4.02 ± 1.14 ng/mL), and IL-1β (5.39 ± 1.27 vs. 3.71 ± 0.87 pg/mL; all P < 0.001). Galectin-3 independently predicted CI (adjusted OR = 1.393; 95 % CI: 1.153–1.681; P < 0.001). Mediation analysis indicated partial mediation by NLRP3 and IL-1β (41.4 % and 36.2 %, respectively). ROC analysis demonstrated good discrimination (AUC = 0.888; cutoff = 15.85 ng/mL; sensitivity = 84.0 %; specificity = 82.0 %). Galectin-3 correlated with PSQI, anxiety, depression, migraine impact, and inflammatory markers after adjustment (all P < 0.001).

Conclusion

Elevated plasma Galectin-3 is strongly associated with CI in CM and shows good predictive value. Its relationship with NLRP3 and IL-1β suggests a shared neuroinflammatory pathway, highlighting Galectin-3 as a potential biomarker for risk stratification and targeted management of CM patients with insomnia.

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.