Analysis Of Serum Lipids Levels In Patients With COPD Combined With OSAHS

Objective:To analyze the serum lipid levels in patients with chronic obstructive pulmonary disease(COPD)combined with obstructive sleep apnea hypopnea syndrome(OSAHS)and explore the mechanism.Methods:A total of 104 inpatients(77 males and 27 famales)who were enrolled to the First Affiliated Hospital of Nanchang University from September 2016 to December2018.Among them,30 patients with chronic obstructive pulmonary disease and obstructive sleep apnea hypopnea syndrome(23 males,7 females,body mass index22.60±3.76 kg/m2,age 70.47±8.02 years old)were included in overlap syndrome(OS)group,33 patients with obstructive sleep apnea hypopnea syndrome(25 males,8 females,body mass index 23.81 ± 2.77kg/m2,age 69.55 ± 9.18 years)and 41 patients with chronic obstructive pulmonary disease(29 males,12 females,body mass index 22.52±2.23 kg/m2,age 70.49±9.17 years).All the patients included in the study underwent pulmonary function tests and polysomnography(PSG)monitoring.And recorded the apnea hypopnea index(AHI),the lowest oxygen saturation(L-SaO2)and the mean oxygen saturation(M-SaO2).All patients underwent fasting venous blood collection,and the serum lipid levels were measured in our laboratory,including total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C).Results:(1)The TC level in the OS group was 5.56±0.57mmol/L,the TG level was 2.71±0.39mmol/L,the HDL-C level was 0.70±0.18mmol/L,and the LDL-C level was4.37±0.65mmol/L.The TC level in the OSAHS group was 4.97±1.02mmol/L,the TG level was 2.26±1.95mmol/L,the HDL-C level was 1.14±0.32mmol/L,and the LDL-C level was 3.08±0.89mmol/L.The TC level in the COPD group was 4.35±0.78mmol/L,the TG level was 0.98±0.50mmol/L,the HDL-C level was 1.41±0.45mmol/L,and the LDL-C level was 2.53±0.71mmol/L.Serum levels of TC and LDL-C in OS group were higher than those in OSAHS group and COPD group(P<0.05).Serum TG level was higher than COPD group,serum HDL-C level was lower than OSAHS group and COPD group(P<0.05).The levels of serum TC,TG and LDL-C in OSAHS group were higher than those in the COPD group(P<0.05),and the serum HDL-C level was lower than COPD group(P<0.05).Though the serum TG level in the OS group was higher than OSAHS group,no statistically significant between the two groups(P>0.05).(2)The L-SaO2 level in the OS group was 69.67±18.36%,and the M-SaO2 level was 89.83 ± 5.25%.The L-SaO2 level in the OSASH group was 78.73 ±12.74%,and the M-SaO2 level was 94.44±4.35%.The L-SaO2 level in the COPD group was 85.29±3.41% and M-SaO2 were 94.02±2.71%.The levels of L-SaO2 and M-SaO2 in OS group were lower than those in OSAHS group and COPD group(P<0.05).The level of L-SaO2 in OSAHS group was lower than that in COPD group(P<0.05),but there was no significant difference in M-SaO2 level(P>0.05).(3)Serum levels of TC,TG and LDL-C in the OS group were positively correlated with AHI(r = 0.690,0.676,0.606,P < 0.05),and negatively correlated with L-SaO2 and M-SaO2(r =-0.653,-0.636,-0.539,-0.567,-0.607,-0.440,P<0.05),serum HDL-C level was negatively correlated with AHI(r =-0.495,P<0.05),and positive correlated with L-SaO2 and M-SaO2(r = 0.425,0.457,P <0.05).Conclusions:(1)Compared with patients with COPD,OSAHS patients have relatively disordered serum lipid metabolism,while OS patients have more severe dyslipidemia than OSAHS patients and COPD patients.(2)According to the results of correlation analysis between serum lipid indexes and sleep monitoring indexes in OS patients,it suggested that the cause of the dyslipidemia may be associated with the more severe sleep-related hypoxemia.