The Level Of Serum Apelin And Its Correlation With Lipid Metabolism And Insulin Resistance In OSAHS Patients

Objectives:To investigate the changes of fasting serum Apelin and insulin level in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients.To study the correlation between serum Apelin level,lipid metabolism and insulin resistance in OSAHS patients and its clinical significance.Methods:59 patients with OSAHS and 16 normal controls were included in the study.The OSAHS patients was divided into mild 24 patients,moderate 13 patients and severe 31 patients group based on the apnea-hypopnea index(AHI).There is no significant distinction between each interclass and control group in years of age and sexuality.All selected people have no history of diabetes mellitus,cardiovascular diseases and chronic respiratory disease.All selected people need to measure the height, weight,circumference of neck,waistline and hip circumference,to calculate the body mass index(BMI)and waist-to-hip ratio(WHR),to carry out multiplying channel sleep monitoring all night for 7 hours at least,analysis apnea hyponea index(AHI), the minimum O2 saturation at night, cumulative percentage of sleep time with SaO2 below 90%(CT<90%), Epworth sleepiness scale(ESS); collecting 4ml empty stomach venous blood on next day early morning,examining fasting serum glucose,blood-fat,Hs-CRP,using ELISA to measure empty stomach insulin and Apelin.Insulin resistance were assessed by Homeostasis Model Assessment method.Results: 1. Circumference of neck,WHR,BMI,ESS,TC,TG,FBG,FINS,HOMA-IR,Apelin and Hs-CRP in the patients with OSAHS were higher in diversity degree (P<0.05), HDL-C levels in OSAHS group were lower than those in the control group(P<0.05).2.By stepwise multiple linear regression analysis of AHI showed that the minimum 02,Apelin and HOMA-IR are the main factors relating the severity of OSHAS.3. Apelin levels in each OSAHS group were significantly higher than those in the control group(P<0.05),severe groups were significantly higher than mild groups(P<0.05);after AHI,the minimum O2 saturation at night and cumulative percentage of sleep time with SaO2 below 90% were controlled,Apelin levels were still significantly correlated to HDL-C,FINS,HOMA-IR(r= -0.267,p<0.01;r=0.543,p<0.001;r=0.421,p<0.001).Conclusion:1.OSAHS patients have the disorders of weight,fasting glucose,lipid and insulin resistance.The disorders were related with the severity of OSAHS.2.By eliminating the effect of hypoxia,the fasting Apelin was significantly related with lipid metabolism and insulin resistance in OSAHS patients.3. Apelin,the minimum O2 saturation at night and HOMA-IR could be predictors of the severity of OSAHS.