Investigation Of The Serum Peroxisome Proliferators-activated Receptor γ Of OSAHS

Objectives: To investigate the change of fasting PPARy in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients.To study interactions between serum PPARy level and body parameters serum lipids,insulin resistance, AHI and other indexs in OSAHS patients.To assess the possible mechanism and significance of the change of fasting serum PPARyin OSAHS patient.Methods: All subjects were intermittently come from the patients who were examined with polysomnography in the Respiratory Department of the First Hospital of Shanxi Medical College from April,2009 to December,2009.According to diagnosis standard of obstructive sleep apnea hypopnea syndrome,they are departed to two groups:fifty people with OSAHS and thirty-five people age-matched normal controls.Subjects in OSAHS group were divided into two sub-groups according to body mass index(BMI):obese OSAHS group (BMI>28kg/m2,n=26)and non-obese group OSAHS(BMI<28kg/m2,n=24). The main sleep parameters were recorded including:AHI, the minimum oxygen saturation,the mean oxygen saturation and the time of oxygen saturation less than 90%.Their height,weight,circumferences of neck,abdominal circumferences,waist and hip were measured.Meanwhile,BMI and WHR were calculated on.Venous blood was sampled in the fasting state for the measurement of PPARy, insulin,lipid and blood glucose. The level of lipid and blood glucose were measured by biochemical analyzer.The level of serum PPARy and insulin were measured by ELISA. Insulin resistance was assessed by Homeostasis Model Assessment method.All indexs were compared between OSAHS patients and controls,and then did correlation analysis between serum PPARy level AHI and others.Results:1.Compared with control subjects,levels of fasting PPARy level were significantly higher in OSAHS subjects (p<0.01);the levels of PPARy in OSAHS obese group were higher than OSAHS non-obese group, but they are all significant correlation(P<0.05).2.The levels of blood glucose, TC, HDL-C, LDL-C between OSAHS and the control group have differences (P<0.05).AHI was positively correlated with LDL-C, glucose and TG(P<0.05), AHI was negatively correlated with HDL-C (p<0.05).3.By stepwise multiple linear regression analysis showed that the risk factors of AHI were augments of the circumferences of neck and abdominal (P<0.05).4. Serum PPARy level was positively correlated with minimum SaO2,the time of oxygen saturation less than 90%,AHI, insulin, HOMA-IR, neck circumference, waist circumference, abdominal circumference, hip circumference,BMIand WHR (P<0.05), and it was negatively correlated with mean SaO2 and HDL-C(P<0.05),and it was not remarkably correlated with blood glucose, TC,TG,LDL-C.Conclusions:1.OSAHS patients have the disorders of blood glucose and lipid metabolism, and the obese is intimately connected with it.2. The PPARy level is increased in OSAHS,and it is positively correlated with the degrees of OSAHS and anoxia.3.The PPARy may participate in regulating insulin resistantce and lipid metabolism in OSAHS patients.