| Objective: To investigate the serum visfatin and resistin levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS). To explore the change of pathophysiology in patients with OSAHS and its complications in order to provide new ideas for its prevention.Methods: Forty-five males with OSAHS were included randomly in the study, who were made a diagnosis by using polysomnography. The standard of diagnosis according to diagnostic standard formulated by group of sleep-breath disease to Chinese Medical Association. According to AHI and the lowest oxygen saturation difference at night,all patients with OSAHS were divided into two groups: mild OSAHS patients (5≤AHI<20, the lowest SpO2≥86%) and moderate and severe OSAHS patients (20≤AHI,the lowest SpO2≤85%), of which mild OSAHS patients with 20 patients, aged 32～65 (43.24±13.32) years, body mass index of 18.81～31.56 (28.97±4.33) kg/m2, moderate and severe OSAHS patients with 25 cases, Age 24～56 (41.92±9.04) years old, body mass index of 22.72～34.29 (29.80±4.31) kg/m2.There were 21 men in control subjects (age=39.35±7.34, BMI=26.37±4.10),who were excluded OSAHS after enquiring patient history and detecting Stardust portable sleep monitor. There were no significant differences in age and BMI among control subjects, mild OSAHS, moderate and severe OSAHS. Smoking, drinking, diets, drugs and other disturbance factors were excluded in this study. All observed subjects in this study were excluded infection, liver and nephridium disease, rheumatic disease, cerebrovascular, malignancy, coronary heart disease and other diseases which can elevate the serum visfatin and resistin levels.Fasting venous blood were obtained from all observed subjects after sleep-breathing monitoring within the following 5 minutes in the next morning. The Serum visfatin and resistin concentrations were measured by ELISA.At the same time,height,weight,serum glucose and serum triglyceride were measured and record the sleep-breathing parameters, including apnea hypopnea index(AHI),percentage of sleep time below 90% oxygen saturation(SaO2<90%), percentage of sleep time the total duration of apnea/hypopnea, the lowest SaO2, average lowest SaO2 and the longest duration of apnea/hypopnea.Serum visfatin and resistin levels were compared respectively among control subjects, mild OSAHS, moderate and severe OSAHS. Sleep-breathing parameters of the later two groups were also compared respectively. Furthermore, to analyze the correlations between the two factors and sleep-breathing parameters in mild OSAHS and moderate and severe OSAHS patients, respectively.Results:1.Serum Visfatin and resistin concentrations were 8.98±4.99 ng/ml,7.07±2.30ng/ml in control subjects, were 16.50±8.37ng/ml,9.97±3.02 ng/ml in mild OSAHS patients and 49.40±24.80ng/ml,14.46±6.31ng/ml in moderate and severe OSAHS patients, respectively. Serum visfatin and resistin were both higher in mild OSAHS patients than control subjects and there were statistical significances(p<0.01). There were similar results in patients with moderate and severe OSAHS compared with control subjects (p<0.01)and in patients with moderate and severe OSAHS compared with mild OSAHS patients (p<0.01).2.Serum glucose and serum triglyceride concentrations were 5.58±0.46mmol/l,1.17±0.16 mmol/l in control subjects, were5.72±0.75 mmol/l,2.05±1.14 mmol/l in mild OSAHS patients and 6.40±1.24 mmol/l,3.14±1.57mmol/l in moderate and severe OSAHS patients, respectively. Serum triglyceride was higher in mild OSAHS patients than control subjects and there were statistical significances(p<0.01), serum glucose has not statistical significances(p>0.05). There were similar results in patients with moderate and severe OSAHS compared with control subjects (p<0.01)and in patients with moderate and severe OSAHS compared with mild OSAHS patients (p<0.01).3. Compared with OSAHS patients, all AHI, SaO2<90% and percentage of sleep time the total duration of apnea/hypopnea were higher in moderate and severe OSAHS patients(t=-11.015, p<0.01; t= -8.776, p<0.01; t= -17.923, p<0.01), both the lowest SaO2 and average lowest SaO2 were lower in moderate and severe OSAHS patients (t=7.130, p<0.01; t=2.410, p<0.05).But there were no differences in the longest duration of apnea/hypopnea between the two groups(t=1.724,p>0.05).4. The linear correlations were found as follows:The serum visfatin levels were correlated positively with serum glucose and serum triglyceride(r=0.512,p<0.01;r=0.589,p<0.01);The serum resistin levels were correlated positively with serum glucose and serum triglyceride(r=0.718,p<0.01;r=0.627,p<0.01);5.The linear correlations were found between the two factors and sleep-breathing parameters in patients with OSAHS and moderate and severe OSAHS as follows:①The serum visfatin levels were correlated positively with AHI in OSAHS patients (r=0.83,p<0.01),were correlated positively with SaO2<90%(r=0.615,p<0.01),were correlated positively with percentage of sleep time the total duration of apnea/hypopnea(r=0.715,p<0.01),were correlated positively with longest duration of apnea/hypopnea(r=0.316,p<0.05), were correlated negatively with the lowest SaO(2r=-0.642,p<0.01),were correlated negatively with the average lowest SaO2 ( r=-0.710 ,p<0.01).②The serum resistin levels were correlated positively with AHI in OSAHS patients (( r=0.67 , p<0.01 ) ,were correlated positively with SaO2<90%(r=0.556,p<0.01),were correlated positively with percentage of sleep time the total duration of apnea/hypopnea(r=0.559,p<0.01), were correlated negatively with the lowest SaO2(r=-0.354,p<0.01),were correlated negatively with the average lowest SaO(2r=-0.46,p<0.01)and were no correlated with longest duration of apnea/hypopnea(r=0.087,p>0.05).Conclusions: 1.Despite controlling for age, BMI and excluding disturbance factors such as smoking, drinking, diets and drugs, the serum visfatin, resistin concentrations in patients with mild OSAHS and moderate and severe OSAHS were higher than those in control subjects. The two factors levels were both correlated positively to AHI, SaO2<90% and percentage of sleep time the total duration of apnea/hypopnea, which showed a strong correlation between the change of visfatin, resistin and the severity of OSAHS. The two factors were both correlated negatively to the lowest SaO2 and average lowest SaO2, which showed a strong correlation between the levels of visfatin, resistin and the degree of hypoxemia. 2. The Serum triglyceride and serum glucose were both higher in OSAHS patients than control subjects and were correlated positively with serum visfatin and resistin, It shows that in patients with OSAHS, visfatin and resistin participated the regulation of glucose metabolism abnormality and glycolipid metabolism abnormality. 3. The serum visfatin and resistin might as important predictors to inspect state of OSAHS, to filtrate those dangerous patients, to supervise therapy and to estimate prognosis. |
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