Abstract：
Background: Sleep can be affected in patients with chronic spontaneous urticaria (CSU). The mechanisms of sleep regulation remain poorly understood. Orexin-A, a neuroexcitatory peptide, plays a role in coordinating sleep-wake states. Ghrelin and leptin are involved in sleep regulation through the orexin system. Objective: The effects of orexin-A, ghrelin, and leptin on sleep quality in patients with CSU have not been investigated. We aimed to determine the effects of CSU on sleep quality and the association between serum orexin-A, ghrelin, and leptin levels, and sleep quality in patients with CSU. Methods: Thirty-three patients with CSU and 34 sex- and age-matched controls were included in the study. Serum orexin-A, leptin, and ghrelin levels, and the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) scores were measured in patients with CSU and in the controls; also used were the chronic urticaria quality-of-life questionnaire score and the urticaria activity score used for 7 consecutive days. Results: Median (minimum-maximum) orexin-A, leptin, and ghrelin levels in patients were 385 pg/mL (90-495 pg/mL), 3.1 ng/mL (0-21.2 ng/mL), and 701.8 pg/mL (101.9-827.7 pg/mL), respectively. Median serum orexin-A and leptin levels were higher in the patients compared with the controls (p < 0.001 and p = 0.012, respectively), whereas the median serum ghrelin levels were similar to the controls (p = 0.616). The serum orexin-A level was positively correlated with ghrelin (r = 0.298, p = 0.014), PSQI sleep quality (r = 0.356, p = 0.003), and ESS (r = 0.357, p = 0.003). Conclusion: Serum orexin-A is associated with sleep quality in patients with CSU. Further studies are needed to elucidate the role of ghrelin and leptin on sleep quality in patients with CSU.
摘要：
背景：慢性自发性荨麻疹（CSU）患者的睡眠可能受到影响。睡眠调节的机制仍然知之甚少。Orexin-A,一种神经兴奋肽，在协调睡眠-觉醒状态中发挥作用。Ghrelin和瘦素通过食欲素系统参与睡眠调节。目的:食欲素A的作用,ghrelin,和瘦素对CSU患者睡眠质量的影响尚未被调查。我们旨在确定CSU对睡眠质量的影响以及血清食欲素A之间的关系，ghrelin,和瘦素水平,CSU患者的睡眠质量。方法：本研究纳入了33例CSU患者和34例性别和年龄匹配的对照。血清食欲素A,瘦素,和ghrelin水平，在CSU患者和对照组中测量匹兹堡睡眠质量指数（PSQI）和Epworth嗜睡量表（ESS）评分；还使用了连续7天使用的慢性荨麻疹生活质量问卷评分和荨麻疹活动评分。结果：中位数（最小-最大）食欲素A，瘦素,患者的ghrelin水平为385pg/mL（90-495pg/mL），3.1ng/mL（0-21.2ng/mL），和701.8pg/mL（101.9-827.7pg/mL），分别。与对照组相比，患者的血清食欲素A和瘦素水平中位数较高（分别为p<0.001和p=0.012），而中位血清ghrelin水平与对照组相似(p=0.616).血清食欲素-A水平与ghrelin呈正相关(r=0.298,p=0.014),PSQI睡眠质量(r=0.356,p=0.003),和ESS（r=0.357，p=0.003）。结论:血清食欲素A与CSU患者睡眠质量相关。需要进一步的研究来阐明ghrelin和leptin对CSU患者睡眠质量的作用。
