Qxidative Stress And Its Correlation With Insulin Resistance Of OSA Patients

Objective:This study investigated the relationship between the oxidative stress level and insulin resistance in patients with obstructive sleep apnea?OSA?with different degrees,and to explore the further possible mechanisms.Methods:65 cases of OSA patients in our outpatient and inpatient hospitals from January 2019 to December 2019were selected,and 30 healthy control groups were selected during the same period.All people were monitored by polysomnography.According to Apnea hypopnea Index?AHI?,the severity of the disease was divided into three groups:the control group?AHI<5 times/hour?,the mild to moderate OSA group?5?AHI?30 times/hour?,and the severe OSA group?AHI>30 times/hour?.And recorded height,weight,waist circumference,neck circumference,ESS score etc.And calculated body mass index?BMI?.The fasting peripheral venous blood of the subjects was collected the next morning,and serum and monocytes were separated.Detectded the fasting blood glucose?FBG?,blood lipid and other indicators,and we used the Enzyme-linked immunosorbent assay?ELISA?to detect serum MDA,SOD,T-AOC,GSH-Px,and FINS levels.Exponential homeostasis model evaluation?HOMA-IR?was used to calculate the insulin resistance index.Western blot was used to determin the expression of Nrf2 and?-GCS proteins in the Nrf2/ARE signaling pathway of peripheral blood mononuclear cells of the subject.Pearson correlation analysis was used to analyze the relationship between Nrf2,?-GCS,MDA,SOD,T-AOC,GSH-Px and various indicators.Stepwise regression analysis was used to analyze the influencing factors of OSA insulin resistance index.P<0.05 means statistical significance.Results:1.The results of ELISA detection of peripheral blood serum MDA,SOD,GSH-Px,T-AOC showed that compared with the control group,the serum MDA level of the mild and moderate OSA group and the severe OSA group increased,and the levels of SOD,GSH-Px,and T-AOC decreased.The difference was statistically significant?P<0.05?;Compared with the mild and moderate OSA Compared with the group,the level of serum MDA increased in the severe OSA group,and the SOD,GSH-Px,T-AOC levels decreased,the difference was statistically significant significance?P<0.05?.2.Compared the change trend in the insulin resistance index?HOMA-IR?among the three groups,the results showed that HOMA-IR in the mild to moderate OSA group and the severe OSA group were higher than the control group,and the difference was statistically significant?P<0.05?.And the change trend of HOMA-IR among the three groups was that the severe OSA group was greater than the mild to moderate OSA group,and the mild to moderate OSA group was greater than the control group.The difference was statistically significant?P<0.05?.3.Nrf2,?-GCS protein in PBMC were detected by Western blot.The results showed that the expression of Nrf2 and?-GCS protein of the control group,the mild to moderate OSA group and the severe OSA group were decreased gradually,and the difference was statistically significant?P<0.05?.4.Pearson correlation analysis showed that HOMA-IR,AHI and MDA were positively correlated,and HOMA-IR,AHI and Nrf2,?-GCS,SOD,GSH-Px,and T-AOC were negatively correlated?P<0.05?;LSa O₂and Nrf2,?-GCS,SOD,GSH-Px,T-AOC were positively correlated.and LSa O₂and MDA were negatively correlated?P<0.05?.Stepwise regression analysis suggested that FINS,FBG,Nrf2,GSH-Px,BMI and AHI were the influencing factors of HOMA-IR in OSA patients?P<0.05?.Conclusions:1.Obstructive sleep apnea patients existed oxidative stress and insulin resistance,and which were related to the severity of the disease.2.The expressions of Nrf2 and?-GCS in peripheral blood mononuclear cells of Obstructive sleep apnea patients were decreased,which were related to disease severity and insulin resistance.3.The dysregulation of Nrf2/ARE signaling pathway might be involved in the pathophysiological mechanism of obstructive sleep apnea patients insulin resistance.