Relationship Of Obstructive Sleep Apnea Hypopnea Syndrome With Bone Metabolic

Backgrounds and Objectives Obstructive sleep apnea hypopnea syndrom(OSAHS) is no longer merely a kind of respiratory disease, but the involvement of the systemic diseases,which is got more and more attention by clinicians.Some studies have showed that there are certain correlation between OSAHS and bone metabolism.To observe the Lumber BMD and serum concentration of25(OH)-VD3\?-Crosslaps(?-CTX)\Total Procollagen Type I Intact N-terminal Propeptide(total PINP)and N-terminal osteocalc in patients with obstructive sleep apnea hypopnea syndrome(OSAHS),and discuss the effect and its clinical significance in bone metabolism disorder caused by OSAHS.Methods From March 2014 to June 2015, to eliminate the effect of women's hormonal levels on bone metabolism, just male adults as subjects were selected in our hospital. To select 94 male patients with OSAHS in sleep detection center, who were all diagnosed by polysomnography(PSG). According to apnea- hypopnea index(AHI) and minimum O2 saturation(Sa O2min),these patients were divided into normal group(19cases) \mild group(12 cases)\moderate group(11 cases)and severe group(52 cases). The age, weight, height, BMI, neck, wacist, smoking and drinking histories, diabetes, coronary heart disease, highpertension and family history of the whole subjects are recorded. And, they all carry out polysomnogram monitoring all night for at least 7 hours, analysis AHI and La SO2 at night by the same technician analysis; dividedly collecting empty stomach peripheral venous blood on next day morning to measure serum concentration of ?-Crosslaps and total PINP by electrochemilumine scence in our hospital laboratory, and lumbar spine bone mineral density(BMD) by radiation absorption.Results 1. The average lumber bone mass density of subjects with mild OSAHS group ?moderate OSAHS group?severe OSAHS group respectively(1.272g/cm2?1.361 g/cm2?1.212 g/cm2),are lower than the control group(1.700g/cm2), the difference is statistically significant(p <0.05),but the difference between OSAHS group is not statistically significant(p > 0.05), 2. The 25(OH)-VD3 serum concentration of subjects with mild OSAHS group ?moderate OSAHS group?severe OSAHS group respectively(20.226 ng/ml?18.802 ng/ml?17.678 ng/ml),are higher than the control group(17.017 ng/ml), the difference is not statistically significant(p >0.05),and the difference between OSAS group is not statistically significant(p > 0.05),too. 3. The ?-Crosslaps serum concentration of subjects with mild OSAHS group ?moderate OSAHS group?severe OSAHS group respectively(0.520pg/ml?0.527 pg/ml?0.533 pg/ml),are higher than the control group(0.486pg/ml), the difference is not statistically significant(p >0.05),and the difference between OSAS group is not statistically significant(p > 0.05),too. 4. The PINP serum concentration of subjects with mild OSAHS group ?moderate OSAHS group?severe OSAHS group respectively(36. 267ng/ml?47.510ng/ml?41.238ng/ml),are lower than the control group(35.567 ng/ml), the difference between the severe OSAHS group and the control group is statistically significant(p=0.048), the difference between the moderate OSAHS group and the control group is statistically significant(p=0.04), the difference between moderate OSAHS group and mild OSAHS group is statistically significant(p=0.012). 5. The N-terminal osteocalcin serum concentration of subjects with mild OSAHS group?moderate OSAHS group?severe OSAHS group respectively(17.207ng/ml?22.37ng/ml?19.935ng/ml),are lower than the control group(22.948 ng/ml), the difference between the severe OSAHS group and the control group is statistically significant(p=0.033), the difference between the mild OSAHS group and the control group is statistically significant(p=0.003), the difference between moderate OSAHS group and mild OSAHS group is statistically significant(p=0.019).Conclusions 1. The average lumber bone mass density of patients with OSAHS is lower than the control subjects; though is not statistically significant among the OSAHS groups,it may be affected by other factors. 2. The PINP serum concentration of patients with OSAHS is higer than the control subjects; and is related with AHI. 3. The N-terminal osteocalcin serum concentration of patients with OSAHS is lower than the control subjects; and is related with AHI. 4. The PINP and N-terminal osteocalcin serum concentration can be used as the timely index of bone metabolic abnormalities in patients with OSAHS,while BMD can be regular index.