Study On The Relationship Between Serum Leptin,Orexin And Ghrelin Levels And Physiological Indexes Related To Sleep Monitoring In Patients With OSAHS

Objective: To observe the changes of serum leptin,orexin and ghrelin levels in patients with OSAHS and their correlation with metabolic indicators and sleep monitoring indicators,provide more evidence for the clinical diagnosis of OSAHS.Method: A total of 58 OSAHS patients from December 2017 to December 2018 at Sheng Jing Hospital of China Medical University,were included in our study.According to the severity of the disease,there were 6 cases in the mild group(AHI5~15),11 cases in the moderate group(AHI > 15~30),and 41 cases in the severe group(AHI > 30).The general data of each patient was recorded.At the night of admission PSG was also recorded.The blood concentrations: oxygen saturation,partial pressure of carbon dioxide,the normal value of blood glucose,lipids,leptin,orexin and ghrelin were also measured in each patient.The relationship between the indicators was analyzed by Spearman correlation.And the relationship between the severity of OSAHS and the indicators was analyzed by ordered logistic regression.Results: AHI was negatively correlated with minimum oxygen saturation(r=-0.664,P<0.01),with BMI,neck circumference,waist circumference,hip circumference,total arousal times,more than 15 seconds of awakening times,and arousal index were positive between blood oxygen and 90%(r = 0.355,0.273,0.386,0.274,0.624,0.345,0.734,0.772,P<0.01~0.05);LEP concentration was negatively correlated with PO2(r=-0.301,P<0.05),positively correlated with BMI,waist circumference,hip circumference,and bedtime SBP(r=0.482,0.429,0.576,0.261,P<0.01~0.05);GHRL concentration and bedtime SBP and bedtime DBP There was a negative correlation(r=-0.391,-0.282,P<0.01~0.05),and there is no correlation with other indicators(P>0.05);OX was only negatively correlated with TIB(r=-0.320,P<0.05)),and there is no correlation with other indicators(P>0.05).Univariate analysis showed that the micro-awakening index,less than 90% blood oxygenation time and minimum oxygen saturation were related to the severity of OSAHS patients,the difference was statistically significant(P<0.05)and was not associated with other factors(P> 0.05).In the multivariate ordered logistic regression model,the micro-awakening index,blood oxygen less than 90% time and minimum oxygen saturation that results of their univariate analysis were statistically significant were included in the multivariate ordered logistic regression model.It was found that T90% was an independent influencing factor for the severity of OSAHS patients(P<0.05),while the micro-awakening index and the minimum oxygen saturation were not independently associated with the severity of OSAHS patients(P>0.05).Conclusion: Our study showed that the interaction of factors such as hypoxia and obesity makes the concentration of leptin in OSAHS patients rise,and leptin resistance gradually appears,which eventually leads to the occurrence of metabolic disorder.The role of orexin in maintaining awakening may be helpful in the treatment of some narcolepsy diseases.The concentration of ghrelin in OSAHS patients plays a critical role in the physiological process of regulating blood pressure,and it is a new direction for the diagnosis and treatment of cardiovascular diseases.T90% can be a certain guiding significance for the assessment of the severity of OSAHS patients,and it can identify high-risk groups more easily and effectively.