The Effect Of Leptin And Obesity On The Pathogenesis Of Obstructive Sleep Apnea-hypopnea Syndrome

ObjectiveTo explore the level of serum leptin in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) and the display of obese receptor (OB-R) in their oropharynx tissues, thereby to explore the effect of leptin and obesity on the pathogenesis of OSAHS. MethodsPolysomnography(PSG) was performed in 53 patients with OSAHS and in 41 simple obesity, both of which had not been treated to OSAHS and had no hypophysis, kidney and adrenal disease, diabetes, hyperthyroidism, hypothyroidism or other endocrinal metabolism diseases. All the patients were tested in PSG for no less than 7 hours. Two tubes of venous blood were drawn from each patient at 7 o'clock the next morning. One tube of venous blood was for abstracting serum with would be stored below minus 20 centigrade to determine serum leptin, the other tube was for testing blood fat, including triglycerides (TG), total cholesterol (TC), high density lipoprotein (HDL) and low density lipoprotein (LDL) .At the same time, the patients' height, weight, neck circumference, abdomen circumference and buttocks circumference were measured. The display of OB-R in the oropharynx tissues was test throughimmunohistochemistry. 18 cases oropharynx tissues specimens of patients with OSAHS after uvulopalatopharyngoplaasy (UPPP) were collected. Control group collected 11 cases oropharynx tissues specimens of simple obesity. The specimens were from palatopharyngeal pillar tissues which were cut while we were performing tonsillectomy on simple obesity who also had chronic tonsillitis. ResultsAfter analyse the patients' age, sex, body mass index(BMI) of the two groups, we found that the age and BMI between two groups don't have distinct difference, the same outcome also appears in the age and BMI of the same sex (PO.05), all of them are comparable. The research show: 1. Serum leptin level in patients with OSAHS was higher, in both male and female (8.06±2.58 ug/L, 12.83±2.67 ug/L) than that in the simple obesity (5.75±1.27 ug/L, 9.83±1.99 ug/L) (PO.05). 2. Serum leptin levels were significantly correlated with BMI in both OSAHS patients and simple obesity, but only in patients with OSAHS was the leptin level significantly correlated with apnea and hypopnea index (AHI) and proportion of neck circumference and waist-hip ratio(WHR). 3. Serum leptin levels and AHI of the patients with OSAHS also correlated with lipomicron, both of them correlated with TG, TC, LDL positively, and correlated with HDL negatively. 4. Oropharynx tissues of two groups both have OB-R, but patents with OSAHS present strong masculine and simple obesity present weak masculine in their oropharynx tissues, they have significant difference (P<0.05 ). Conclusions1. Leptin is one kind of circular hormone excreted by lipocyte. It regulate energy metabolizing feeding action and avoirdupois balance, accelerate fat decomposition, restrain fat composition by combining directly with leptin OB-R from nerve centre. The serum leptin of the two groups all rise, but in different degrees. The serum leptin of patients with OSAHS is higher than simple obesity.2. The serum leptin level not only correlated with proportion of neck...