The Level Of Adiponectin And Its Correlate Analysis In Obstructive Sleep Apnea-hypopnea Syndrome Patients

Objectives:To investigate the change of fasting serum adiponectin in obstructive sleep apnea-hypopnea syndrome(OSAHS)patients.To study the correlation between serum adiponectin level and the main sleep parameter,insulin resistance,leptin in OSAHS patients.To assess the reason of the change of fasting serum adiponectin and the role of serum adiponectin in the development of OSAHS.Methods:fourty males with OSAHS and fourty age-matched male normal controls were included in the study.Subjects in OSAHS group were divided into two sub-groups according to body mass index(BMI):obese OSAHS group(BMI≥25 kg/m~2,n=26),non-obese group OSAHS (BMI＜25 kg/m~2,n=14).OSAHS subjects underwent an overnight sleep study.The main sleep parameters were recorded including:AHI and the minimum oxygen saturation.Their height, weight,circumferences of neck,waist and hip were measured.Meanwhile,BMI were calculated on.Venous blood was sampled in the fasting state for the measurement of adiponectin,leptin and insulin.The levels of serum adiponectin and leptin were measured by ELISA and The levels of serum insulin by radioimmunoassay.Insulin resistance was assessed by Homeostasis Model Assessment method.Serum adiponectin level,fasting insulin level,HOMA-IR,Serum leptin level,circumferences of neck,waist and hip,BMI and age were compared between OSAHS patients and controls.The correlations of serum adiponectin level and sleep parameters were analyzed.Then the correlation between serum adiponectin level and insulin resistance,serum insulin and leptin level was evaluated in OSAHS patients,respectively.Results:1.Except for BMI,compared with control subjects,levels of fasting adiponectin level were significantly lower in OSAHS subjects(p＜0.05).Conversely,levels of fasting insulin,HOMA-IR and leptin were significantly higher in OSAHS subjects than that in control subjects (p＜0.05).2.In obese OSAHS sub-group,serum adiponectin level was negatively correlated with AHI(r=-0.538 p＜0.01).However,serum adiponectin level was positively correlated with the minimum oxygen saturation(r=0.787,p＜0.05).There were similar correlations between serum adiponectin level and sleep parameters in non-obese OSAHS sub-group(AHI:r=-0.775,p＜0.05; the minimum oxygen saturation:r0.741,p＜0.05).3.In whichever sub-group,obese OSAHS sub-group or non-obese OSAHS sub-group,serum adiponectin level was negatively correlated with fasting insulin level(r=-0.702,-0.661;p＜0.05,p＜0.05),HOMA-IR(r=-0.788,-0.713; p＜0.01,p＜0.01),there is similar correlation with leptin(r=-0.444,p＜0.05)in obese OSAHS sub-group.Conversely,there is no significant correlation in non-obese OSAHS sub-group (r=-0.213;p＞0.05).Conclusions:Despite for age and BMI,fasting adiponectin level was significantly lower in OSAHS patients than that in control subjects.And fasting adiponectin level was correlated with BMI,AHI and the minimum oxygen saturation.OSAHS is one of the main reasons of the decreased adiponectin.The decreased level of serum adiponectin were correlated with increased fasting insulin level,HOMA-IR and fasting leptin level independently of BMI.Lower level of serum adiponectin is related with hyperleptinemia and hyperinsulinemia in OSAHS patients. Adiponectin may be a defensive factor of OSAHS.