Study On The Relationship Between Oxidative Stress,Proinflammatory Factors And Perimenopausal Sleep Disorders

Objective: The occurrence of perimenopausal sleep disorder seriously affects the physical and mental health of perimenopausal women.The changes of serum melatonin(MT),inducible nitric oxide synthase(i NOS),hypoxia inducible factor-1α(HIF-1α),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)may have been associated with the occurrence of perimenopausal sleep disorders.This study aimed to explore the relationship among the levels of serum MT,i NOS,HIF-1α,TNF-α,IL-6 and sleep quality in perimenopausal women in order to obtain the pathophysiological mechanism for providing the ideas and theoretical guidance of the prevention and treatment of perimenopausal sleep disorders.Methods:From March 2019 to January 2020,127 perimenopausal women(54 cases in the sleep disorder group and 73 cases in the non-sleep disorder group)were selected from the Affiliated Hospital of Inner Mongolia Medical University.The information of Pittsburgh sleep quality index(PSQI)of these perimenopausal women was collected to evaluate their sleep quality.The General data,estradiol 2(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),patient health questionaire-9(PHQ-9)and generalized anxiety disorder-7(GAD-7)were collected,and 5ml of subjects’ venous blood was collected.The levels of MT,HIF-1α,TNF-α and IL-6 in serum were measured by enzyme-linked immunosorbent assay,and levels of i NOS were detected by colorimetry.Results: 1.Comparing the scores of PHQ-9 and GAD-7 between the two groups,the results showed that the global scores of PHQ-9 and GAD-7 in the sleep disorder group were higher than those in the non-sleep disorder group,and the differences were statistically significant(P < 0.05).2.the level of i NOS in the sleep disorder group was lower than that in the non-sleep disorder group,and the level of IL-6 was significantly higher than that in the non-sleep disorder group(P < 0.05).3.In the sleep disorder group:(1)the level of i NOS was negatively correlated with PSQIC5(P < 0.05);(2)the level of IL-6 was positively correlated with PSQIC5 and PSQIC7(P < 0.05);(3)PHQ-9was positively correlated with PSQIC1,PSQIC5,PSQIC7 and PSQI global scores(P < 0.05);(4)GAD-7 was positively correlated with PSQIC3,PSQIC7 and PSQI global scores(P < 0.05).4.In the non-sleep disorder group:(1)the level of IL-6 was positively correlated with PSQIC4(P < 0.05);(2)PHQ-9 was positively correlated with PSQIC1,PSQIC7 and PSQI globalscores(P < 0.05);(3)GAD-7 was positively correlated with PSQIC1,PSQIC5,PSQIC7 and PSQI total scores(P < 0.05),and GAD-7 was linearly positively related to PSQIC1 and PSQIC5,respectively(P < 0.05).5.We used logistic regression analysis.The dependent variable was whether there was sleep disorder or not.The results showed that PHQ-9,i NOS and IL-6 entered into the logistic regression equation,indicating that PHQ-9,i NOS and IL-6are the important influencing factors of perimenopausal sleep disorders.Conclusion: 1.High level of depression,high level of IL-6 and low level of i NOS may be the important causes of sleep disorders in perimenopausal women.Depression and IL-6 are the risk factors,while i NOS is the protective factor;2.Depression and anxiety affect the daytime function of perimenopausal women,while the high level of IL-6 in the serum of perimenopausal women with sleep disorder will aggravate the daytime dysfunction;3.Perimenopausal women’s frequent complaints about sleep problems may be closely related to their own subjective feelings of anxiety;4.During perimenopause,the decrease of serum E2 and the increase of FSH were related to the decrease of MT level.