Effects Of Continuous Positive Airway Pressure On Cognitive Function And Expression Of Related Nerve Factors,inflammatory Factors In Patients With OSAHS

Objective:To evaluate cognitive function and serum levels of MBP,BDNF,IGF-1,IL-1β,IL-6 in patients with Obstructive Sleep Apnea Hypopnea Syndrome（OSAHS）and study its correlates.To observe the effect of continuous positive airway pressure（CPAP）on cognitive function in OSAHS patients.Methods:Eligible 63 patients were collected from the Affiliated Hospital of Hangzhou Normal University during December 2017 to June 2019.They were divided into three groups:mild OSAHS group（n=23）,moderate OSAHS group（n=20）and severe OSAHS group（n=20）.In addition,22 healthy subjects were selected as control group.Cognitive function was assessed by The Montreal Cognitive Assessment（Mo CA）.Serum levels of myelin basic protein（MBP）,brain-derived neurotrophic factor（BDNF）,insulin-like growth factors-1（IGF-1）,Interleukin-1β（IL-1β）and Interleukin-6（IL-6）were measured using ELISA Results.Pearson correlation test was used to analyze the correlation of Mo CA scores,serum index and PSG parameters.The patients in moderate-severe OSAHS were evaluated at baseline and after CPAP therapy.Results:（1）PSG parameters:ODI,AHI were significantly increased in moderate to severe OSAHS groups compared to control group（P<0.05）;LSa O₂,MSa O₂ were significantly decreased in moderate to severe OSAHS groups compared to controls group（P<0.05）;（2）Montreal cognitive assessment:Mo CA score was significantly decreased in severe OSAHS group compared to control group（P<0.05）;（3）Serum MBP,BDNF,IGF-1:Serum levels of MBP was significantly increased in moderate to severe OSAHS groups compared to control group（P<0.05）;Serum levels of BDNF was significantly decreased in moderate to severe OSAHS groups compared to control group（P<0.05）;Serum levels of IGF-1 was significantly decreased in severe OSAHS group compared to control group and mild to moderate OSAHS groups（P<0.05）;（4）Serum IL-1β,IL-6:Serum levels of IL-1β,IL-6 were significantly increased in OSAHS group compared to control group;（5）Pearson correlation test:Mo CA score showed positive correlation with serum levels of BDNF,IGF-1（r=0.487,r=0.530,P<0.05）,and negative correlation with serum levels of MBP,IL-1β,IL-6（r=-0.322,r=-0.479,r=-0.356,P<0.05）;（6）Patients use CPAP experienced a marked improvement in serum levels of MBP,BDNF,IL-1β,IL-6 in moderate to severe OSAHS groups after three months（P<0.05）;Severe OSAHS group showed a marked improvement in serum levels of IGF-1（P<0.05）,whereas no changes was observed in the moderate OSAHS group after CPAP therapy（P>0.05）.Conclusion:Cognitive impairment is related to serum levels of MBP,BDNF,IGF-1,IL-1βand IL-6 in patients with OSAHS.Cognitive impairment can benefit from CPAP therapy.CPAP therapy can attenuate inflammatory response and regulate serum levels of MBP,BDNF and IGF-1 in patients with OSAHS.Serum MBP,BDNF,IGF-1,IL-1βand IL-6 may play an important role in cognitive impairment in patients with OSAHS.