The Significance Of Serum Cystatin C In Obstructive Sleep Apnea Syndrome Patients And The Correlation With Coronary Heart Disease

Objective To observe the effects of serum cystatin C(Cys C) in different gradings of obstructive sleep apnea hypopnea syndrome(OSAHS), and the correlation with coronary heart disease in patients with OSAHS, to explore the effects of OSAHS intermittent hypoxia on oxidative stress and feedback effect on coronary heart disease.Method 120 cases who took the monitoring polysomnography(PSG) in department of respiratory medicine in our hospital during 2012-2014 were retrospectively studied,including26 cases of mild OSAHS patients(SOM group), 26 cases of moderate OSAHS patients(OM group), 31 cases of severe OSAHS(OS group), 16 cases of OSAHS patients combined with coronary heart disease(OC group), and 21 healthy subjects were selected as normal control group(NC group). the patient’s clinical data was recorded, monitoring indicators of polysomnography include: apnea hypopnea index(AHI), oxygen desaturation index(ODI), the lowest oxygen saturation(LPO2), mean oxygen saturation(MPO2), the detection of oxidative stress indicators(Cys C, CRP), the calculation of body mass index(BMI), blood lipid liver enzymes. The differences between such groups were compared and analyzed.Results(1) Within the five groups, the difference in gender, hypertension, smoking was significant(P=0.030, 0.000, 0.019); showing an increasing of the proportion of old people, hypertension and smoking when the degree of OSAHS was increased; and the increasing of BMI had a significant difference(P<0.001), suggesting that with the increase of OSAHS level, there was more overweight or obviously obese patients.(2) With the increase of OSAHS level, serum Cys C level showed a rising trend. The difference was statistically significant in NC group, SOM group, OM group, OS group and OC group(all P<0.05), suggesting that with the increase of OSAHS level, the level of oxidative stress in patients increased. And compared with the mild OSAHS patients, oxidative stress levels were significantly increased when the patients complicated with coronary heart disease.(3) In NC group, SOM group, OM group, OS group and OC group, the levels of blood glucose, serum lipid and uric acid significantly increased, the difference is statistically significant(P<0.05).(4) The Pearson correlation analysis showed that, Cys C is positively correlated with BMI, UA, AHI, ODI(P<0.05), and negatively correlated with LPO2 and MPO2(P<0.05)..(6)Patients with moderately-severe oashs recived a noninvasive positive pressure ventilation treatment, serum Cys C level can be decreased obviously, prompt it is associated with oshas severity.Conclusion Serum Cys C elevated in OSAHS patients, and rises with the severity of OSAHS. Logistic regression analysis showed serum Cys C levels may be specific indicators for the severity of OSAHS.OSAHS may play an important role in the development of the occurrence of coronary heart disease through oxidative stress.CPAP can improve oxidative stress level in patients with OSHAS, may relieve or prevent the occurrence of OSAHS associated cardiovascular disease development.