Association Between Obstructive Sleep Apnea Hypopnea Syndrome And Urinary Microalbumin Creatinine Ratio In Male

Purpose: Obstructive sleep apnea hypopnea syndrome(OSAHS)had a high correlation with renal damage,Urinary microalbumin creatinine ratio(UACR)was a sensitive and reliable index for early diagnosis of renal damage,but it is not clear that the relationship between OSAHS and UACR.The purpose of this study was to investigate the factors affecting the change of UACR level in male patients with OSAHS and evaluate the relationship between UACR level and OSAHS,so we can do early detection and early intervention for OSAHS patients with renal damage and provide a reasonable and effective treatment to reduce the risk of kidney disease in patients with OSAHS.Methods: Consecutive male patients with sleep disordered breathing who underwent polysomnography between February 2016 to February 2017 were included.Patients with a history of urinary tract disease,cardiovascular disease,cerebrovascular disease,rheumatic blood disease and a variety of original,secondary glomerular disease history were excluded.All subjects were measured the height and the weight and examined by polysomnography.Two tube Clean mid urine 10 ml were taken from all subjects to respectively analyze levels of Urinary microalbumin and creatinine,UACR ratio was calculated.Blood samples were selected from all patients to analyze levels of uric acid,urea nitrogen,total cholesterol,triglyceride and other indicators.According to apnea hypopnea index(AHI),we divided all subjects into control group,mild,moderate and severe OSAHS group.Appropriate statistical methods were used to compare the changes of UACR levels in each group.Spearman correlation analysis was used to understand the factors associated with UACR level,and multiple regression analysis was used to know the independent risk factors for UACR.Results: A total of 109 male subjects were included.According to the AHI,all objects were divided into control group(n=26),mild OSAHS group(n =24),moderate OSAHS group(n = 30),and severe OSAHS group(n = 29).Compared with the control group,neck circumference,waist circumference,BMI,systolic blood pressure,diastolic blood pressure,AHI,ODI,T90%,La SO2,average Sp O2 and ESS in OSAHS group showed significant difference(P < 0.05).Age,hypertension,diabetes,hyperlipidemia and smoking did not show significant difference(P>0.05).Mild OSAHS group(4.5[2.26-31.04]mg/g),moderate OSAHS group(10.4[5.63-35.93] mg/g),severe OSAHS group(21.12[10.77-83.19] mg/g)had a higher UACR ratio than that the control group(3.26[2.35-5.47] mg/g)(P<0.05).UACR and BMI(r=0.461),neck circumference(r=0.383),waist circumference(r=0.313),diastolic blood pressure(r=0.189),systolic blood pressure(r=0.238),AHI(r=0.820),ODI(r=0.869),T90%(r=0.860)and ESS(r=0.620)were positively correlated(P < 0.05),and ASp O2(r=-0.714)?La SO2(r=-0.544)were negatively correlated(P < 0.05).Multiple linear regression analysis showed that ODI(?=0.470,adjusted r2=0.696,P =0.018)was the independent risk factor of elevated levels of UACR.Conclusions: 1.The level of UACR could reflect the early damage of renal function,it was significant to evaluate the severity of early renal function and disease control efficacy in patients with OSAHS.2.ODI was an independent risk factor of elevated levels of UACR,and OSAHS-related intermittent hypoxia might be a risk factor for early renal damage.