The Levels And Significance Of Serum IL-18,MMP-9 And TIMP-1 In Tibetan Patients With OSAHS At Medium And High Altitude

Objective:To investigate the levels of serum interleukin-18(IL-18),matrix metalloproteinase-9(MMP-9)and tissue inhibitor of metalloproteinases-1(TIMP-1)in tibetan male patients with obstructive sleep apnea hypopnea syndrome(OSAHS)in medium and high altitude,and to explore its clinical significance in the pathogenesis of OSAHS and OSAHS-related cardiovascular and cerebrovascular diseases.Methods:The tibetan male patients with OSAHS at medium and high altitude were selected as the experimental group,all patients completed the monitoring of polysomnography(PSG)and recorded their apnea hypopnea index(AHI).According to AHI,the patients with OSAHS were divided into 3 groups:mild OSAHS,moderate OSAHS,reverse OSAHS.And selected the snoring patients and healthy subjects as snoring group and control group.The levels of serum IL-18,MMP-9 and TIMP-1 were detected by enzyme-linked immunosorbent assay(ELISA),and the correlation with AHI was analyzed.Results: 1.There was no significant difference between(mild,moderate,and severe)OSAHS group,snoring group and control group at age and BMI in medium and high altitude(P>0.05).and there was no significant difference in AHI between the corresponding groups in different altitudes(P>0.05).2.The levels of serum IL-18 and MMP-9 in(mild,moderate,and severe)OSAHS group were higher than those in snoring group and control group at the same elevation(P<0.05).The levels of TIMP-1 were not significantly different between the groups at the same elevation(P>0.05).The levels of serum IL-18,MMP-9 and TIMP-1 in the high altitude were higher than those in the medium altitude(P< 0.05).The levels of serum IL-18 and MMP-9 in OSAHS group were positively correlated with AHI at the same elevation?medium altitude(r=0.839),(r=0.813);high altitude(r=0.945),(r=0.860)?,(P< 0.01).3.The level of serum IL-18 in OSAHS group was positively correlated with MMP-9 at the same elevation.(medium altitude r=0.946,high altitude r=0.827),(P<0.01).Conclusions: 1.The levels of serum IL-18 and MMP-9 in(mild,moderate,and severe)OSAHS group were higher than those in snoring group and control group at the same elevation,and were positively correlated with AHI.It may suggeste that the levels of serum IL-18 and MMP-9 are associated with OSAHS and increase with the severity of OSAHS.2.The level of serum IL-18 in OSAHS group was positively correlated with MMP-9 at the same elevation.It showed that OSAHS patients have a high level of inflammatory factors,and a variety of inflammatory factors associated with each other.thus further suggested that OSAHS may be an inflammation-related diseases.IL-18,MMP-9 and TIMP-1 may mediate the development and progression of OSAHS-related cardiovascular and cerebrovascular diseases.3.The levels of serum IL-18,MMP-9 and TIMP-1 in the high altitude were higher than those in the medium altitude.It may indicate that the plateau environment characterized by low pressure and hypoxia is one of the reasons for the upregulation of inflammatory factors.