| Obstructive sleep apnea syndrom (OSAS) is a common disease, which apnea, hypopnea often occurs in sleep and causes hyoxemia, hypercarbia, acidaemia and other pathophysiological changes. With increase of obese population, the number of patients with OSAS rises rapidly, and OSAS patients combined with diabetes, cardiovascular disease and cerebrovascular disease increases obviously. Recently some researchers regarded OSAS as a part of metabolic syndrome (MS) which insulin resistance is the central component. Recent researches have found that Leptin is the product of obese gene, composing of 146 amino-acids. Leptin is also a kind of endogenous hormone secreted by adipose tissue, adjusting body weight and adipose distribution. Regardless of male or female, serum leptin levels in patients with OSAS were higher than those in simple obesity, and increased by the higher apnea and hypoapnea index (AHI). But little is known about the relationship between serum leptin level and insulin resistance in patients with OSAS. In this study, we observed fasting plasma glucose (FPG) levels, fasting insulin (FINS) and fasting leptin levels (LP) in these cases, in order to explore the relationship between leptin and insulin resistance in patients with OSAS by compartial relationshipanalyze.Part one Relationship of leptin and insulin resistance in OSAS and obese patientsMethods: Polysomnography were performed in all cases. These cases were divided into four groups by BMI and AHI: groups A obese OSAS (BMI≥27, AHI≥ 5), groups B non-obese OSAS (BMK25, AHI≥5), groups C simple obese(BMI≥27, AHI<5), groups D nomal conctrol (BMI<25, AHI<5). FPG levels were measured by glucose-oxidase, FINS and LP were measured by radioimmunoassay. Homeostasis model assessment insulin resistance (HOMA-IR) and fasting beta cell function index (FBCI) were calculated according to FPG and FINS level in these cases.The relationship between serum leptin level and insulin resistance in patients with OSAS was analyzed by compartial relationship analyze.Result: ①The FPG levels of group A, B, C and D were 5.68±0.32 mmol/L, 5.71±0.55 mmol/L, 5.65±0.43 mmol/L and 5.14±0.57 mmol/L, and the FINS levels of four groups were 15.64±3.59 mU/L, 11.65±2.32 mU/L, 11.28±2.47 mU/L and 9.13±1.8 mU/L. The FPG and FINS levels of group A, B and C were higher than those of group D (P<0.05~0 01), and FINS levels of group A were also higher than those of group B and C (P<0.01) .②The LP levels of four groups were 6.63 ± 1.4 μ g/L, 4.66 ± 0.9 μg/L, 4.23 ± 0.7 μ g/L and 3.39±1.0 μ g/L; the LP levels in group A, B and C were higher than those of group D (.P<0.05~0.01), and LP levels of group A were also higher than those of group B and C (P<0.01). (3)The HOMA-IR of four groups were 3.95±1.38, 2.98±0.78, 2.82±0.56 and 2.10±0.55; the FBCI of four groups were 2.76±0.65, 2.04±0.33, 2.00±0.55 and 1.76±0.31. The serum HOMA-IR and FBCI of group A, B and C were higher than those of group D (P<0.05~0.01), HOMA-IR and FBCI of group A were also higher than those of group B and C (P<0.01) . ④Leptin levels of patients with OSAS were obviouslycorrelated with BMI, FINS and Homa-IR, the coefficient were 0.7543 (P<0.01), 0.4312 (P<0.05),0.4074 (P<0.05) and 0.4352 (P<0.05).Part two Relationship of leptin and insulin resistance in different degree OSASMethod Polysomnography were performed in all cases.These cases were divided into three group by AHI of OSAS: group A middle and severe OSAS (AHI ≥20), group B mild OSAS (AHI 5~20) , group C nomal conctrol (AHI <5) . FPG levels were measured by glucose-oxidase, FINS and fasting leptin levels were measured by radio-immunoassay. HOMA-IR and HBCI were calculated according to FPG and FINS level in these cases. The relationship between serum leptin level and insulin resistance in patients with OSAS was analyzed with compartial relationship analyze.Result: ①The FPG levels of groups A, B and C were 5.64±0.38 mmol/L, 5.60±0.54 mmol/L and 5.16±0.59 mmol/L, The FPG levels of group A and B were higher than those of group C (P<0 05). The FINS levels of three groups were 16.36±3.14 mU/L, 11.42±1.85 mU/L and 8.95±1.56 mU/L. The FINS levels in group A and B were higher than those of group C (P<0 01), and FINS levels in group A were also higher than those of group B (PO.01) .②The LP levels of three groups were 6.87±1.08 μg/L, 5.10±0.82 μ g/L and 3.43±0.99 μ g/L, the LP levels of group A and B were higher than those of group C (P<0 01), and LP levels of group A were higher than those of group B (P<0.01). ③The HOMA-IR of three groups were 4.12±0.94, 2.84±0.56 and 2.07±0.53, the FBCI were 2.9±0.51, 2.06±0.38 and 1.72±0.24. The HOMA-IR and FBCI of group A and B were higher than those of group c (P<0.05~0.01), HOMA-IR and FBCI of group A were also higher than those of group B (P<0.01) . ④Leptin levels of patients with OSAS were correlated with BMI, FINS, Homa-IR and FBCI, the coefficient were: 0.4994( P<0.01), 0.5200( P... |
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