Study On The Level Of Irisin And Inflammatory Factors In Type 2 Diabetes Mellitus Patients With OSAHS

Objective Obstructive sleep apnea syndrome(OSAHS)is a clinical syndrome that occurs frequently during sleep,accompanied by a decrease in blood oxygen saturation.Type 2 diabetes mellitus(T2DM)has a close relationship with OSAHS.OSAHS can increase the levels of TNF-α,hs CRP,LEP and IL-6,which will aggravate insulin resistance and increase the risk of cardiovascular and cerebrovascular diseases.Muscle factor irisin(also known as irisin)plays an active role in sports metabolism and diabetes.However,there is no study on the serum irisin level of T2 DM combined with OSAHS.The purpose of this study was to investigate the serum levels of irisin,TNF-α,hs CRP,IL-6 and LEP in T2 DM patients with OSAHS,and to explore their correlation with type 2 diabetes mellitus and sleep apnea.Methods In this study,57 patients who were hospitalized in the Second Affiliated Hospital of Qingdao University from December 2016 to August 2019 and met the diagnostic criteria of T2 DM formulated by who in 1999 were selected as the case group,and 23 healthy controls were selected from the physical examination center in the same period.According to the diagnostic criteria of guidelines for the diagnosis and treatment of obstructive sleep apnea hypopnea syndrome(2011 Revision),T2 DM patients were divided into group A(T2DM with OSAHS)27 cases and group B(T2DM without OSAHS)30 cases,and group C was the control group of 23 cases.The levels of FBG,fins,Hb A1 c,TC,TG,LDL-C and hs CRP were measured in our laboratory.The serum levels of irisin,TNF-α,LEP and IL-6 were measured by ELISA in our central laboratory.SPSS 22.0 statistical software was used for statistical processing.The experimental data were all expressed as mean ± standard deviation.Chi square test was used for the counting data of the three groups.One way ANOVA was used for the comparison of the mean of the three groups.Dunnett’s T3 method was used for the comparison of the mean of group A and group B with the control group.LSD method was used for the comparison of the mean of the three groups.P < 0.05 was statistically significant.Spearman correlation analysis was used for simple correlation.Multiple stepwise linear regression analysis was performed in each group.Result There was no significant difference in sex ratio,age,course of disease and blood lipid level among the three groups(P > 0.05).FBG in group A and B was higher than that in control group,and BMI and waist circumference in group A and B were higher than those in control group(P < 0.05).A.The Hb A1 c of group B was higher than that of group C,and that of group A was higher than that of group B(P < 0.05).The AHI of group A was higher than that of group B and control group,and the lowest Sa O2 at night was lower than that of group B and control group(P < 0.05).The serum irisin concentration in group A was significantly lower than that in group B and C,and that in group A was significantly lower than that in group B(P < 0.05).The serum irisin level was negatively correlated with BMI,FBG and HOMA-IR(P < 0.05),and positively correlated with the lowest Sa O2 at night(P < 0.05).The levels of TNF-α,hs CRP,leptin and IL-6 in group A were higher than those in group B and C,and those in group A were higher than those in group B(P < 0.05).TNF-α,hs CRP,IL-6 and leptin were positively correlated with homair,FBG and AHI(P < 0.05),and negatively correlated with the lowest Sa O2 at night(P < 0.05).Multiple stepwise linear regression analysis showed that AHI and HOMA-IR were the factors influencing irisin,among which AHI was the independent negative factor.The factors influencing TNF-α were AHI and FBG.The factor affecting hs CRP was the lowest Sa O2 at night.The factors influencing IL-6 were AHI and the lowest Sa O2 at night.The influencing factors of leptin were HOMA-IR and AHI.Conclusion The serum irisin level of T2 DM patients with OSAHS was lower than that of T2 DM patients without OSAHS,and also lower than that of the normal control group.AHI was an independent influencing factor.In T2 DM patients with OSAHS,chronic low activity inflammation is more serious,TNF-α,HSCR,IL-6 and LEP are higher,AHI and insulin resistance are the main influencing factors.