Investigation Of Relationship Between Visfation Of OSAHS With Insulin Resistance And Metabolism Of Blood Lipid

Objectives:To investigate the change of fasting visfatin in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients.To study correlation between serum visfatin level and serum lipids,insulin resistance,body mass index,waist-to-hip ratio, AHI and other indexs in OSAHS patients.To assess the reason of the change of fasting serum visfatin and the role of serum visfatin in the development of OSAHS.Methods:Fifty people with OSAHS and thirty-five people age-matched normal controls were included in the study.Subjects in OSAHS group were divided into two sub-groups according to body mass index(BMI):obese OSAHS group (BMI≥28kg/m2,n=26),non-obese group OSAHS(BMI<28kg/m2,n=24).All the people underwent an overnight sleep study.The main sleep parameters were recorded including:AHI, the minimum oxygen saturation,the mean oxygen saturation and the time of oxygen saturation less than 90%.Their height,weight,circumferences of neck,abdominal circumferences,waist and hip were measured.Meanwhile,BMI and WHR were calculated on.Venous blood was sampled in the fasting state for the measurement of visfatin, insulin,lipid and blood glucose.The level of serum visfatin and insulin were measured by ELISA. The level of lipid and blood glucose were measured by biochemical analyzer.Insulin resistance was assessed by Homeostasis Model Assessment method. Serum visfatin level,fasting insulin level,HOMA-IR,lipid level and fasting blood glucose were compared between OSAHS patients and controls.Then the correlation between serum visfatin level and insulin resistance,serum insulin, fasting blood glucose, circumferences of neck,abdominal circumferences,waist and hip was evaluated in OSAHS patients,respectively.Results:1.Compared with control subjects,levels of fasting visfatin level were significantly higher in OSAHS subjects (p<0.01); The level of visfatin in OSAHS obese group was higher than OSAHS non-obese group, but it has no significant correlation(p> 0.05); The serum visfatin levels of OSAHS non-obese is higher than the control group, but no significant difference (p> 0.05). The level of visfatin in OSAHS obese group was higher than the control group (p<0.01).2.The levels of blood glucose, TC, HDL-C, LDL-C between OSAHS and the control group have significant differences (P<0.05).AHI was positively correlated with LDL-C, glucose and TG(p <0.05), AHI was negatively correlated with HDL-C (p<0.05).3.By stepwise multiple linear regression analysis showed that the factors AHI was affected by lowest SaO2, the time of SaO2<90%and increased neck circumference (p<0.05).4. Serum visfatin level was positively correlated with BMI, WHR, neck circumference, waist circumference, abdominal circumference, hip circumference, AHI, blood glucose, insulin, HOMA-IR, TC and TG (p<0.05), and it was negatively correlated with the minimum SaO2 and mean SaO2 (p<0.05).5. By stepwise multiple linear regression analysis showed that insulin resistance and increased neck circumference were the risk factors for visfatin (p<0.01).Conclusions:1. OSAHS patients have the disorders of blood glucose and lipid metabolism, lipid and glucose disorders were related with the severity of OSAHS.2. The increased neck circumference is the risk factor for OSAHS.3. Insulin resistance and increased neck circumference were the risk factors for raising visfatin levels.4. Both OSAHS and obese can raise the visfatin levels, the serum visfatin level was correlated with the severity of OSAHS and the disorders of blood glucose and lipid metabolism. Serum visfatin level could be one of the predictors of OSAHS complicated with glucose and lipid metabolism disorder.