The Relationship Between The Serum Insulin-Like Growth Factor-1 And Lipoprotein (a) In Patients With Obstructive Sleep Apnea-Hypopnea Syndrome

Objectives This thesis aims to analyze the relativity between theseverity of OSAHS , serum IGF-1 and LP(a) level through assessing theserum insulin-like growth factor-1(IGF-1) and lipoprotein a [LP(a)]levelin the patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and discuss the abnormal mechanism of OSAHS patients' blood-fat andphlogosis factors.Design Cross-sectional study.Setting Sleeping lab Xiangya Hospital, Central South University,Changsha, ChinaSubjects 80 patients were chosen through the test of PSG, amongwhich 14 patients are diagnosed with mild OSAHS(5≤AHI＜15),12patients with mediate OSAHS (15≤AHI＜30),44 patients with severeOSAHS (AHI≥30) and 10 patients(AHI＜5) as control group. Theiraverage age is 49.50 years old.Method All the subjects' serum insulin-like growthfactor-1(IGF-1) and lipoprotein a[LP(a)] were determined byenzyme-linked immunosorbnent assay. The associations between thebaseline characteristics, IGF-1, LP(a), and polysomnographic parameterswere examined by simple regression analysis and stepwise multipleregression analysis.Results1. All of the polysomnographic parameters, IGF-1 and LP(a) level hadstatistical significance in the four groups of the subjects. Comparedwith the control group, OSAHS groups'Ⅰ.Ⅱsleep period ratioincreased, Slow Wave Sleep (SWS) and Rapid Eye Movement (REM)ratio decreased, Microarousal Index (MAI) increased, night LowestOxygen Saturation (LSaO2) and Mean Oxygen Saturation (MSaO2)decreased, IGF-1 level decreased and LP(a) level increased.2. The IGF-1 level was significantly correlated with the PSG parameters.It had negative correlation with AHI (r=-0.630, p＜0.01)andⅠ.Ⅱsleep period ratio (r=-0.975, p＜0.01); it had positivecorrelation with SWS (r=0.949, p＜0.01) and REM (r=0.921, p＜0.01); it had negative correlation with MAI (r=-0.562, p＜0.01)and it had positive correlation with LSaO2 (r=0.604, p＜0.01) andMSaO2 (r=0.448,p＜0.01).3. LP(a) level were significantly correlated with the PSG parameters. Ithad positive correlation with AHI (r=0.315, p＜0.01) andⅠ.Ⅱsleepperiod ratio (r=0.323, p＜0.01); it had negative correlation with SWS(r=-0.318, p＜0.01) and REM (r=-0.297,p＜0.01); it had positivecorrelation with MAI (r=-0.317, p＜0.01) and it had negativecorrelation with LSaO2 (r=-0.299,p＜0.01) and MSaO2 (r=-0.253,p＜0.01)4. LP(a) had negative correlation with IGF-1 level.5. Stepwise multiple regression analysis revealed that IGF-1 level wasinfluenced by the factors ofⅠ.Ⅱsleep period (-0.933) andLSaO2(0.074); LP(a) level was influenced by the factor ofIGF-1(-0.330).Conclusions1. Abnormal level of IGF-1 and LP(a) indicates the endocrine andblood-fat metabolic disorder of the OSAHS patients.2. The serum IGF-1 of OSAHS patients is mainly influenced bynight oxygen deficit degree and sleeping structure, whichindicates oxygen deficit and sleeping structure disorder are themain reasons for the endocrine disorder of OSAHS patients.3. OSAHS patients' LP(a) has significant increase and is correlatedwith IGF-1 level.