Study On The Correlation Between Serum HIF-2?,EPO/EPOR Levels And Erythrocyte,Hemoglobin And Other Indices In Tibetan And Han OSAHS Patients

Objective: To investigate the correlation between serum HIF-2?,EPO,EPOR levels and clinical indicators such as red blood cells(RBC),hemoglobin(Hb),hematocrit(HCT)in Tibetan and Han patients with obstructive sleep apnea hypopnea syndrome(OSAHS)in Qinghai province,and to analyze the differences in adaptability of Tibetan and Han patients to chronic intermittent hypoxia.Methods: 33 Tibetan male and 36 Han male OSAHS patients diagnosed by polysomnography(PSG)from September 2017 to December 2018 in the affiliated hospital of Qinghai university were collected,and the cases were screened strictly according to the inclusion and exclusion criteria.They were divided into 4 groups according to nationality and altitude,including group H1: 36 cases of Han OSAHS patients lived at 2262m;group T1: 11 Tibetan OSAHS patients lived at 2262m;group T2: 10 Tibetan OSAHS patients lived at 2500m~3500m,and group T3: 12 Tibetan OSAHS patients lived at >3500m.All the subjects took venous blood in the morning of the second day after admission without oxygen inhalation.The RBC,HCT and Hb were measured,and the concentrations of HIF-2?,EPO and EPOR of serum were measured by ELISA.Results: 1.There were no significant differences of HIF-2?,EPO,EPOR and RBC,HCT,Hb among Han and Tibetan groups lived at 2260m(all P>0.05);There were no significant differences of HIF-2?,EPO,EPOR and RBC,HCT,Hb among 3 Tibetan groups(all P>0.05).2.The level of HIF-2? of Han OSAHS patients was positively correlated with EPO and EPOR(r= 0.348,0.478,P<0.05),didn't correlate with RBC,HCT and Hb(all P>0.05);The levels of EPO and EPOR didn't correlate with RBC,HCT and Hb(all P>0.05).RBC,HCT,Hb were negatively correlated with the mean arterial oxygen saturation during sleep(all P<0.05),positively correlated with the percentage of time spent in arterial oxygen saturation lower than 90% in total sleep time(all P<0.05),and no correlation with sleep apnea hypopnea index(all P>0.05).3.There was no correlation between HIF-2? and EPO,EPOR,RBC,HCT,Hb in Tibetan groups(all P>0.05).The levels of EPO and EPOR didn't correlate with RBC,HCT and Hb(all P>0.05).RBC,HCT,Hb were negatively correlated with the mean arterial oxygen saturation and the lowest arterial oxygen saturation during sleep(all P<0.05),and positively correlated with the percentage of time spent in arterial oxygen saturation lower than 90% in total sleep time(all P<0.05),but didn't correlate with apnea hypopnea index(all P>0.05).4.There were no significant difference in the number of patients with secondary polycythemia among 4 groups(P>0.05).Conclusions: 1.Tibetans didn't show better adaptability to chronic intermittent hypoxia compared with Han.2.Lower arterial oxygen saturation during sleep affected erythropoiesis in OSAHS patients.3.Single morning blood sample may not accurately reflect the levels of HIF-2?,EPO and EPOR during sleep in OSAHS patients.