Association Between Serum Hepatocyte Growth Factor And OSAHS With Hypertension

Background and Objectives:obstructive sleep apnea hypopnea syndrome(OSAHS) is a highly prevalent respiratory disorder at least 2% to 4% of adult and characterized by repetitive airflow obstruction caused by total or partial collapse of the upper airway during sleep with intermittent hypoxemia,hyperemia and disorder of sleep structure.OSAHS is the most important disease in respiratory disorder.The impair caused by it are intermittent hypoxemia and disorder of sleep structure,and is very easy to cause cardiovascular disease.More and more study demonstrated that OSAHS has been linked to increased prevalence of hypertension, coronary heart disease,stroke, heart failure and pulmonary hypertension,and is a major independent risk factor for cardiovascular disease,and has been considered to be the primary cause for secondary hypertension.OSAHS patients who are untreated have a mortality in 11% to 13% during 5 years,and the death mainly caused by cardiovascular disease. Endothelial dysfunction play an important role in the pathogenesis of atherosclrosis,and it is the initiating factor for atherosclerosis. The damage of endothelial structure and function have become the occurrence and development of the basis of the main pathological of certain cardiovascular diseases. The clinical detection of vascular endothelial function has important significance for early diagnosis, curative effect and prognosis in cardiovascular disease. So the relationship between OSAHS and vascular endothelial function are growing concern about. Cell adhesion molecules are a kind of surface membrane glycoprotein which can regulate the combination between cells,cell and extracellular matrix.They play an important role in the regulatory of cell reaction on the surrounding environment.They are important pro-inflammatory media and participate in leukocyte adhesion and the process of seeping.They can be used as a sensitive observation indicators for endothelial cell function. The study found the levels of serum ICAM-1 and VCAM-1 increased in OSAHS patients.The continued increasing of serum ICAM-1 and VCAM-1 levels prompt there is persistent inflammation in vascular endothelial in OSAHS patients, and may reflect the changes in vascular endothelial function in OSAHS patients. Hepatocyte growth factor(HGF) also is a endothelial cell specific growth factor found in recent years,and play a protective role for vascular endothelial. And it had been found that HGF system had an abnormal expression in cardiovascular disease such as hypertension, atherosclerotic disease, myocardial infarction and congestive heart failure. HGF may be a new indicator to reflect vascular endothelial function,and provide a new idea for diagnosis and treatment of cardiovascular disease. At present,the reports of the level of serum HGF and the relationships between HGF and ICAM-1,VCAM-1 are still rare.Serum levels of HGF, ICAM-1 and VCAM-1 in 58 cases of OSAHS patients and 61 cases of OSAHS with hypertension patients were measured,and the relationships between HGF and ICAM-1,VCAM-1,. apnea hyponea index(AHI), lowest SaO2(LSaO2) were analyzed in this study to investigate the change of serum HGF in OSAHS patients and OSAHS with hypertension patients and the role of HGF in the occurrence and development of OSAHS and OSAHS with hypertension,and provide a new prevention and treatment method for OSAHS and OSAHS with hypertension.Objects and methods:58 cases of OSAHS patients:male 50,female 8,average age (47.3±5.4) years,60 cases of OSAHS with hypertension patients:male 51,female 9,average age (49.6±5.9) years and 50 controls:male 43,female 7,average age (48.7±5.3) years.They were measured on serum HGF,ICAM-1 and VCAM-1 by the enzyme-linked immunosorbent assay(ELISA). Polysomnography used Sandman Elite polysomnography system produced by Tyco company in America and blood pressure was measured by standard mercury column cuff sphygmomanometer.The association between serum HGF levels and AHI, LSaO2, blood pressure and ICAM-1 and VCAM-1 levels.Results:The levels of serum HGF,ICAM-1 and VCAM-1 in OSAHS group and OSAHS with hypertension group were significantly higher than in the controls (P<0.05) and the serum HGF,ICAM-1 and VCAM-1 levels in OSAHS with hypertension group were higher than in OSAHS group(P<0.05).Severe OSAHS group and moderate OSAHS group had significantly increased serum HGF levels compared with mild OSAHS group (P<0.05, P<0.05).OSAHS with severe hypertension group had significantly increased serum HGF levels compared with OSAHS with mild hypertension group and OSAHS with moderate hypertension group(P<0.05,P<0.05).The levels of HGF in OSAHS group were positively related to AHI(r=0.552,P<0.05),and negatively related to LSaO2(r=-0.328,P<0.05).The levels of HGF in OSAHS with hypertension group were positively related to AHI,SBP,DBP(r=0.670,P<0.01;r=0.535,P<0.05; r=0.424,P<0.05),and negatively related to LSaO2(r=-0.572,P<0.01).The levels of HGF in OSAHS group and OSAHS with mild hypertension group positively related to ICAM-1(r=0.623, P<0.05; r=0.495, P<0.05)and VCAM-1(r=0.548, P<0.05; r=0.536, P<0.05).Conclusions:Serum HGF levels are increased significantly in patients with OSAHS and more significantly in patients with OSAHS with hypertension,and are positively related to AHI,ICAM-1,VCAM-1,and negatively related to LSaO2. This indicates that elevated levels of serum HGF in OSAHS patients and OSAHS with hypertension patients is closely related with endothelial dysfunction, and,suggestes that HGF is involved in the pathogenesis in OSAHS patients and OSAHS with hypertension patients, the activation of its signal transduction process or to increase its expression may be new ways to prevent and treat for OSAHS patients and OSAHS with hypertension patients.