Relationship Between Serum Adiponectin And Congnitive Impairment In Patients With Obstructive Sleep Apnea-hypopnea Syndrome

PurposeObstructive sleep apnea-hypopnea syndrome?OSAHS?is the most common clinical sleep apnea syndrome,which can cause cognitive impairment in patients.Current research findings The cognitive impairment in patients with OSAHS is the result of multiple factors.Adiponectin?ADP?is a specific protein secreted by fat before it enters the blood circulation and may be involved in improving cognitive function.In this paper,the plasma adiponectin levels in patients with different severity OSAHS were measured to investigate the relationship between serum adiponectin and the severity of cognitive impairment in patients with obstructive sleep apnea syndrome?OSAHS?.MethodWe collected the patients who referred from our sleep respiratory disease diagnosis and treatment center due to repeated snoring,apnea,and daytime sleepiness during nighttime sleep from February 2016 to February 2017.All patients were asked about detailed medical history after admission,including sleep symptoms,disease history and medication history,smoking history,drinking history,living and work environment,etc.and completed the Epworth sleepiness scale?ESS?and MMSE scores,MoCA volume table.According to the level of AHI,they were divided into control group,mild OSAHS group,moderate OSAHS group and severe OSAHS group.All patients were routinely monitoring by polyapnea monitoring,and the elbow vein blood samples were collected from the next morning fasting for about5ml.After centrifugation,the supernatant was retained and the level of adiponectin was detected uniformly.All the data were analyzed by SPSS19.0 statistical software.Result155 patients were included in the study,including 21 in the control group,41in the mild group,40 in the moderate OSAHS group,and 53 in the severe OSAHS group.There was no difference in years of schooling,glycated hemoglobin,total cholesterol,high-density cholesterol lipoprotein,alcohol drinking history,diabetes mellitus and hypertension among the four groups,The P value was greater than0.05.There was significant difference in age,BMI,neck circumference,waist circumferenc.AHI,ODI,TS 90%,ESS scores increased with the severity of OSAHS,LaSO₂ decreased with the severity of OSAHS,and all P values were less than 0.05.The serum adiponectin levels decreased with the severity of OSAHS,the P values was less than 0.001.MMSE total score and total score of MoCA scale decreased with the severity of OSAHS,all P values were less than 0.001,which was statistically significant.The serum adiponectin level in patients with OSAHS was positively correlated with the total MMSE score,the total MoCA scale scores.The correlation coefficients were 0.660 and 0.680,respectively.All P values were all less than 0.05,which was statistically significant.Adiponectin levels were positively correlated with the MMSE scores,and the correlation coefficients of orientation,memory,attention and calculation,recall and language abilities were0.188,0.516,0.476,0.466 and 0.436,respectively.All P values were all less than0.05,which was statistically significant.Adiponectin level was positively correlated with memory function,executive ability,attention and computational ability in MOCA scale,and the correlation coefficients were 0.510,0.413,0.541and 0.539,respectively.All P values were all less than 0.05,which was statistically significant.The serum adiponectin in patients with OSAHS was negatively correlated with AHI,ODI,TS90%and ESS.The correlation coefficients were-0.771,-0.621,-0.527 and-0.403 respectively.All P values was less than 0.05,and the difference was statistically significant.After adjusting for confounding fators,multiple linear regression showed that AHI and adiponectin were the main predictors of MMSE total score??values were-0.603,0.255,respectively;P values were less than 0.001,0.006,respectively?,while AHI and adiponectin were the main predictor of MoCA scale score.The main predictor??values were-0.640,0.279;P values were less than 0.001,0.001?.ConclusionSerum adiponectin levels decreased with the severity of OSAHS,and it was positively correlated with MMSE scores and total MoCA scale scores.And it was also an independent predictor of total score of MMSE and MoCA.Therefore,this study found that low levels of serum adiponectin are closely related to cognitive impairment of OSAHS.It suggests that the decrease of adiponectin may be involved in the occurrence and development of cognitive impairment in OSAHS patients.