Study On The Relationship Between Obstructive Sleep Apnea Hypopnea Syndrome And Metabolic Syndrome, Adiponectin, C-reactive Protein

Background :The field of sleep apnea and other sleep-disordered breathing syndromes has been among the most rapidly evolving within the discipline of otolaryngology and head and neck surgery. An intrinsic sleep disorder that is often referred for an otolaryngologist's evaluation is Obstructive sleep apnea hypopnea syndrome (OSAHS). Patients with OSAHS have an apnea-hypopnea index of more than five events per hour of sleep and usually have upper airway resistance and usually have accompanying loud snoring, sleep- disordered breathing, blood oxygen saturation decrease, excessive daytime sleepiness and other symptoms. Currently, OSAHS is considered to be the source of a variety of chronic systemic diseases. Insulin resistance is the pathophysiology foundation of Metabolic syndrome (MS). MS is composed of a series of syndromes such as hypertension, hyperglycemia, hyperlipemia and hyperuricacidemia, which are all risk factors of cardiovascular disease. MS is the most principal factor in the development of cardiovascular disease. More and more scholars have paid attention to the relationship between MS and OSAHS. Adiponectin levels and C-reactive protein (CRP) levels in serum are closely related to the metabolic syndrome. Adiponectin is one of the important regulatory factors in the regulation network of lipids metabolism and blood sugar homeostasis. It can reduce the level of blood sugar and blood fat and strengthen insulin resistance, anti-inflammatory and antagonistic role in atherosclerosis sclerosis. CRP level rising in serum can be used to assess the occurrence of acute complications and prognosis in atherosclerosis. Therefore, we can speculate that OSAHS may affect the adiponectin levels and CRP levels and the determination of adiponectin and CRP level may evaluate the risk of cardiovascular disease. In our study, we compared blood pressure, fasting serum glucose, blood fat, adiponectin, CRP in both OSAHS group and control group ,then discussed whether the obstructive sleep apnea hypopnea syndrome (OSAHS) was associated with the metabolic syndrome. Furthermore, we detected adiponectin levels and CRP levels in serum of OSAHS patients and analyzed whether their levels were relative to combined with MS.Methods: According to apnea-hypopnea index (AHI), the OSAHS patients were divided into mild, moderate and severe groups: severe OSA (AHI>40, 21 males), moderate OSA (200.05). The severe group of OSAHS had higher TG levels.(P<0.05). CHO levels in severe and moderate group of OSAHS were different with other groups.(P<0.05)Patients with OSAHS suffered from hypertension and dyslipidemia. There was also significant difference among the mild, moderate and severe group with the development of OSAHS (P<0.05). Fasting blood glucose had no significant difference. The incidence of complicating the metabolic syndrome in patients with different pathogenetic condition had statistical differences(P<0.05). The complication of the metabolic syndrome in the severe group of OSAHS was much higher than that in other groups(P<0.05). It was found that the serum adiponectin levels were lower and CRP levels were higher in the subjects with OSAHS than that in those without OSAHS. Multiple stepwise regression analysis showed that the lowest arterial oxygen saturation was an independent risk factor resulting in the decrease of serum adiponectin levels while BMI and The apnea-hypopnea index value during sleep did not. The apnea-hypopnea index value was an independent risk factor resulting in the increase of serum CRP levels, while BMI and the lowest arterial oxygen saturation during sleep did not. Furthermore, among the patients with OSAHS, the serum adiponectin levels were lower and the CRP levels were higher in moderate and severe groups of OSAHS (P<0.05) , and the serum adiponectin levels were lower and the CRP level were higher with the complication of the metabolic syndrome than in those without metabolic syndrome (P <0.05).Conclusions: We investigated whether the components of metabolic syndrome were associated with OSAHS in nonobese patients. OSAHS is associated with the components of metabolic syndrome and its overall prevalence. The serum adiponectin levels were lower and the CRP levels were higher with the complication of the metabolic syndrome in OSAHS . Therefore, the complication of metabolic syndrome may become an additive cardiovascular risk factor in subjects with OSAHS.