The Influence Of Vascular Endothelial Growth Factor And Insulin-Like Growth Factor-1 On Heart In Patients With Obstructive Sleep Apnea Syndrome

Objective: To evaluate the roles of VEGF and IGF-1 on formation process of "Sleep apnea heart" by learning the cardiac structure and function and the levels of VEGF and IGF-1 in serum in patients with obstructive sleep apnea syndrome.Method: 40 untreated male patients and 15 BMI matched controls were recruited for this study.Polysomnography(PSG) was administered to all subjects in Sleep Disorders Center .Cardiac structure and function were measured by using M-mode and two-dimension echocardiography in all subjects.VEGF and IGF-1 level were measured by in-house enzyme-linked immunosorbent assay(ELISA) technique.Results:1. Results of PSG recording: (1) The age of each group have no difference; (2)Apnea -Hypopnea Index(AHI) of severe OSAS group was higher than that of others groups(P <0.01,respectively), that of moderate OSAS group was higher than that of light OSAS group and control group(P<0.01, respectively), that of light OSAS group was higher than that of control group(P<0.01); (3)Body Mass Index(BMI) of severe OSAS group was higher than that of others groups(P<0.01, P <0.01, P <0.05, respectively); (4)Lowest SaO2 of severe OSAS group was lower than that of others groups(P<0.01, respectively), that of moderate OSAS group was lower than that of light OSAS group and control group( P<0.01, respectively), that of light OSAS group was lower than that of control group( P<0.05); (5)Mean SaO2 of severe OSAS group was lower than that of others groups(P <0.01, respectively), that of Moderate OSAS group was lower than that of control group(P<0.05), that of light OSAS group was lower than that of control group( P<0.05); (6)Noctural Apnea time % of severe OSAS group was lower than that of others groups(P <0.01, respectively), that of moderate OSAS group was lower than that of light OSAS group and control group (P<0.01, respectively); (7)There was higher prevalence(50%) of hypertensionin patients with OSAS than that in control group(P<0.01).2. Results of echocardiography: (1)To compare with control group,there was obvious dilatation in Left ventricular(P<0.01); (2) To compare with control group, moderate OSAS group displays dilated right ventricular,thickened RV,dilated right atrium ,dilated pulmonoay artery and dilated LV(P<0.01, respectively),increased LVmass(P<0.05),marked impaired diastolic function of RV(P<0.05) and LV(P<0.01); Moderate OSAS group displays thickened RV and dilated RA(P<0.05,respectively), marked impaired diastolic function of LV(P<0.01) comparing with light group; (3)Severe group displays dilated RV, RA , LV, LA and pulmonary artery, thickened RV,left ventricular wall and interventricular septum and increased LVmass(P<0.01,respectively); Marked impaired systolic function of RV (P<0.01) and LV(P<0.01) and diastolic function of RV(P<0.01) and LV(P<0.01) and LV(P<0.01) comparing with control group; To compare with light OSAS group,severe group displays dilated RA ,RV, LA and pulmonary artery,thickened RV,left ventricular wall and interventricular septum and increased LVmass(P<0.01,respectively); Marked impaired systolic function of RV(P<0.01) and LV(P<0.01) and diastolic function of RV(P<0.01) and LV(P<0.01); To compare with moderate OSAS group,severe group displays dilated RA(P<0.01),RV(P<0.01),LA(P<0.01) and pulmonary artery(P<0.05), thickened RV(P<0.01),LV(P<0.05),marked impaired systolic function of RV(P<0.01) and diastolic of RV and LV(P<0.05,respectively); (4)There was higher prevalence(45%) of pulmonary hypertension in Patients with OSAS than that in control group(13.3%)(P<0.05).3. The levels of VEGF in each group of patients with OSAS were higher than those in control group(P<0.05,P<0.01,P<0.01,respectively); besides,those in severe group were higher than those in light group and moderate group(P<0.01,P<0.05, respectively);those in moderate group were higher than those in light group(P<0.05);The levels of IGF-1 in moderate group and severe group were reduced significantly comparing with those in control group(P<0.01, res...