Study On The Correlation Between Serum Catalase,Glutathione Peroxidase,Lipid Peroxidation Levels And OSAHS,OSAHS Associated Hypertension

Objectives:To investigate the serum oxidized low density lipoprotein (OX-LDL),total-antoxidant capability (T-AOC) levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) without complications and in those with obsturctive sleep apnea-hypopnea syndrome associated hypertension (OSAHS+HT). To evaluate the relationship between the two biochemical parameters and OSAHS and OSAHS+HT in order to explore the change of oxidant stress in patients with OSAHS and OSAHS+HT. To study the role of serum OX-LDL,T-AOC levels in the pathogenesis and progress of OSAHS and OSAHS+HT.Methods:46 males with OSAHS were included randomly in the study, who were made a diagnosis by using polysomnography (PSG),the standard of diagnosis according to diagnostic standard formulated by group of sleep-breath disease to chinese medical association.All patients with OSAHS were divided into two subgroups:22 OSAHS patients without complications (age=42.86±7.07,BMI=27.68±3.41kg/m2)and 24 OSAHS+HT patients(age =41.25±7.70,BMI=29.12±2.49 kg/m2), Occurrence of hypertension was later than that of OSAHS in patients with OSAHS+HT. Other secondary hypertension (such as renovascular and endocrinic hypertension) were excluded in OSAHS+HT patients. There were 24 males in control subjects (age=40.08±7.47,BMI=27.66±2.04kg/m2),who were excluded OSAHS and HT, there were no significant differences in ages and BMI among control, OSAHS and OSAHS+HT subjects. 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,cerebrovacular,malignancy diabetes mellitus,coronary heart disease and other diseases which can affect the serum catalase, glutathione peroxidase, lipid peroxidation 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 OX-LDL levels were measured by enzyme-linked immunosorbent(ELISA) method,the serum T-AOC levels were detected by colorimetric method, respectively.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.Differences in serum oxidized low density lipoprotein,total-antoxidant capability among three groups were assessed by using one-way analysis of variance and further multiple comparisons were performed with SNK-q test. Sleep-breathing parameters of patients with OSAHS without complications were compared with those of patients with OSAHS+HT by using student's two- tailed t test. Furthermore, linear correlations were performed between two biochemical parameters and sleep-breathing parameters of patients with OSAHS and OSAHS+HT, respectively.Results:1. the serum OX-LDL,T-AOC levels:1.1 the serum OX·LDL levels:in control subjects were 7.06±0.49mg/dl, in patients with OSAHS were 10.84±1.15mg/dl, in patients with OSAHS+HT were 12.79±1.13mg/dl.1.2 the serum T-AOC levels:in control subjects were12.48±1.22U/ml, in patients with OSAHS were 10.05±0.7 U/ml, in patients with OSAHS+HT were8.56±0.64 U/ml.1.3The serum T-AOC levels were lower, serum OX-LDL concentrations were higher in patients with OSAHS compared with those in control subjects. There were statistical significances (p<0.01). There were similar results in patients with OSAHS+HT compared with those in control subjects and in patients with OSAHS+HT compared with OSAHS patients(p<0.01, respectively).2. Compared with OSAHS patients, both AHI and percentage of sleep time below 90% oxygen saturation (SaO2<90%) and percentage of sleep time the total duration of apnea/hyponea were higher in OSAHS+HT patients (t=-5.17,-2.91,-4.11;p<0.01, p<0.05, p<0.05), both the lowest SaO2 and average the lowest SaO2 were lower in OSAHS+HT patients (t=4.37,3.89; p<0.05,p<0.05). But there were no differences in the longest duration of apnea/hypopnea between two groups(t=-1.86,p>0.05).3. The linear correlations were found between the two biochemical parameters and sleep-breathing parameters in patients with OSAHS and OSAHS+HT as follows:The serum OX-LDL levels were correlated positively with AHI,percentage of sleep time SaO2<90%,percentage of sleep time the total duration of apnea/hyponea both in OSAHS and OSAHS+HT patients, were correlated negatively with the lowest SaO2 and average the lowest SaO2·The correlations were not found between the longest dutation of apnea/hypopnea and OX-LDL. The correlations between serum T-AOC and sleep-breathing parameters were not as same as those of OX-LDL levels. The serum T-AOC levels were correlated negatively with AHI,percentage of sleep time SaO2<90%,percentage of sleep time the total duration of apnea/hyponea both in OSAHS and OSAHS+HT patients, were correlated positively with the lowest SaO2 and average the lowest SaO2·And there were no correlations with the longest dutation of apnea/hypopnea.Conclusions:1. There are oxidative stress and oxidative damage in OSAHS patients no matter with or without hypertension, and oxidative damage happened independent of, and possibly prior to hypertension.2. Compared with sleep-breathing parameters, the severity and degree of hypoxemia in patients with OSAHS+HT were more seriously than OSAHS patients.Oxidative stress may be one of the reasons caused hypertension in OSAHS patients.Our study demonstrated the change of oxidative /anti- oxidative imbalance in patients with OSAHS and OSHAS+HT,and it is more obvious in patients with OSHAS+HT.The information of the severity of sleep disordered breathing and the degree of oxidative stress can be obtained by measuring the change of the two biochemical parameters, which has important value to advice the early treatment and to improve the prognosis.