A Preliminary Study Of Sex Hormone Levels On3~8year Old Children’s Obstructive Sleep Apnea Hypopnea Syndrome

Background and objectiveObstructive sleep apnea-Hypopnea syndrome(OSAHS) is a disease happenddurning sleep with apnea、hypopnea、hypoxemia，accompany by sleep disorder thatwill invlove multiple systems,evidences have show the strong relationship betweenOSAHS and hypertension、coronary heart disease、endocrine disorder、seniledementia、delayed growth、infertility and sex disorders et al. Studies abroad foundthat OSAHS is interrelated with male sexual dysfunction,they detected sex hormonelevel and found that patients with OSAHS,especially in patients with severeOSAHS,serum sex hormone levels was below the normal level.they believe theexistence of association between OSAHS and sex hormones.Studies in adultpatients with OSAHS found that because of long-term recurrent sleep apnea andintermittent hypoxia,the hypothalamic-pituitary-gonad axis was damaged,thusdisordered the homeostasis,and influenced the secretion of hormones, leading tosexual dysfunction.For the importance of the former childhood and adolescence tohuman reproductive system, HPGA abnormalities may lead to abnormal secretionof sex hormones,thereby affecting the body’s puberty starts.Previous studies of sexhormone levels measured for preschool children with OSAHS and its possibleimpacts on HPGA is little,we consider the necessity to conduct research on childrenwith OSAHS about the influence to hormone levels、body’s puberty start andphysical growth.Our study by detecting the levels of sex hormone levels ofpreschool children with and without OSAHS,by comparing the diffrences,furtherexploring the impacts of OSAHS on the preschool sex hormone levels、pubertystarts and physical growth.Provide some basis for the choice of clinical treatment for OSAHS children.Methods（1）Experimental Subjects:1.OSAHS group: Continuous enrolling patients between January2012toJanuary2013who visit the Otolaryngology Head and Neck Surgeryat in Children’sHospital of Hunan Province. These patients were diagnosed with OSAHS by takena seven hours of continuous nocturnal polysomnography(PSG),all in the group are76cases. Of which55males and21females, mean age (61.04±13.67) months, theage range (3-8) years, mean height (109.10±9.33) cm, mean body weight (19.42±4.57) kg, duration of disease0.5-5years.2.Control group: Random enrolling patients between January2012to January2013who visit the Otolaryngology Head and Neck Surgery at in Children’s Hospitalof Hunan Province complainted of four、formerfistula,etc，asking no previoushistory of snoring or respiratory were enrolled in control group, all in the group is40cases. Including20males and20females, mean age (62.54±12.89) months, theage range (3-8) years, mean height (117.20±7.92) cm, mean body weight (23.81±6.87) kg.（2）Experimental Methods:1.Using PDx PHLIPS polysomnography device produced in the U.S Alicecompany for OSAHS group’s PSG examnination. The examnination includingnose and mouth airflow, thermal flow, patient event, abdominal breathing exercises,posture, pulse oximetry and so on.2.Using the ACCESS automated chemiluminescent microparticleimmunoassay analyze produced in the U.S. Beckman Coulter company andBeckman Coulter ACCESS dedicated kit using radioimmunoassay for all studysubjects serum Testosterone (T), Estradiol (E2), Follicle-stimulating hormone (FSH),Luteinizing hormone (LH) and Prolactin (PRL) level detection, all subjects’s bloodare collected in the early morning.3.Grouping according to4different way:sex、Body Mass Index(BMI）、apnea hypopnea index(AHI) and duration of disease.（3）StatisticalAnalysis:Collect and collate all the data,using SPSS17.0statistical software to deal withexperimental data for statistical analysis, Two sets of data are non-normallydistributed，using Mann-Whitney test the to compare the difference between twosets of data for analysis,using the Kruskal-Wallis test to compare differrncesbetween multiplesets of data for analysis,using Pearson’s coefficient test to analysisthe correlation between the two factors.Among the factors to set α=0.05,with P<0.01was considered very statistically significant， P <0.05was consideredstatistically significant, P>0.05for the difference considered not statisticallysignificant. Set relationship between factor’s as rs，0<rs<1as positive related,-1<rs<0as negtive related.Results（1）basic data compare:1.Data compared between the OSAHS patients and the control group showedno significant differences in age constraction（P>0.05）. The height and weight ofOSAHS group is significant lower than the control group and the difference isstatistically significant (P=0.035)(P=0.041).（2）sex heermone level of preschool children’s OSAHS:1.Male OSAHS patient’s E2level is higher than the control group’s and showedsignificant statistical difference (P=0.000). Male OSAHS patient’s FSH level issignificantly lower than male control’s and showed significant statistical difference(P=0.000). T、LH and PRL levels between the male control group and femaleOSAHS group have differences but no statistically significant(P>0.05).2.Female OSAHS patient’s E2level is higher than the control group’s andshowed significant statistical difference (P=0.000). Female OSAHS patient’s FSHlevel is significantly lower than male OSAHS patient’s and showed significantstatistical difference (P=0.000). T、LH and PRL levels between the female controlgroup and male OSAHS group have differences but no statistically significant(P>0.05).3. E2、T、FSH、LH and PRL levels between control group of male and femalehave differences but no statistically significant(P>0.05).4.Group according to BMI,compare the differences inner OSAHS groupbetween different BMI groups, the sex hermone levels between underweightOSAHS group、normal OSAHS group、overweight OSAHS group have differencesbut no statistically significant(P>0.05).Compare the differences inner control groupbetween different BMI groups, the sex hermone levels between underweight controlgroup、normal control group and overweight control group have differences but nostatistically significant(P>0.05).5.Group according to AHI，compare the differences inner male OSHAS groupbetween different AHI groups, the sex hermone levels between mild hypoxiagroup、 moderate hypoxia group and severe hypoxia group have differences but nostatistically significant(P>0.05).Compare the differences inner female OSAHSgroup between different AHI groups, the sex hermone levels between mild hypoxiagroup, moderate hypoxia group, severe hypoxia group have differences but nostatistically significant(P>0.05).6.Group according to duration of disease,compare the differences innerOSAHS group between different duration of disease, the sex hermone levelsbetween zero to one year group、one to two years group and above two years grouphave differences but no statistically significant(P>0.05).（3）the relationship between sex hermone and height and weight:1.There are positive relationship between E2、 T and height、(0<rs<1)(P=0.019)、(P=0.017),other sex hermone have no relationship betweenheight(P>0.05).2.There are no relationship between E2、T、FSH、LH、PRL and weight(P>0.05).Conclusions1. OSAHS might influence children’s weight and height;2. OSAHS might influence E2、FSH’s level; 3. The negative feedback regulation in children of3-8year’s old with OSAHS issensitive;4. The HPGA in children of3-8year’s old with OSAHS is still not open;5. E2、T might influenc children’s height.Postgraduate:Yang siyi (Otolaryngology)...