Correlation Analysis Of Intestinal Flora Characteristics And Cytokine Levels In Patients With Different Degrees Of OSAHS

Objective:To analyze intestinal flora diversity,richness and cytokines levels in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)of different severity,and to explore the intestinal flora characteristics and related mechanisms of patients with OSAHS.Method:Patients diagnosed with OSAHS after improved polysomnography(PSG)monitoring in The First Affiliated Hospital of Soochow University from June 2021 to December 2022 were selected.According to the sleep apnea hypopnea index(AHI)in the international classification standard of sleep disorders,the patients were divided into mild OSAHS group(11 cases)and moderate to severe OSAHS group(23 cases).In addition.Control group(12 cases)were selected from healthy subjects who were monitored by PSG and excluded from OSAHS in The First Affiliated Hospital of Soochow University during the same period.A total of 46 cases were included.In the morning after the completion of polysomnosis monitoring,stool samples and 10ml fasting venous blood were collected.Metagenomic next-generation sequencing(mNGS)was used to analyze the characteristics of intestinal flora,and serum cytokines including IL-17a,IL-10,TNF-α,and IL-6 levels in each group were detected by enzyme-linked immunosorbent assay.Clinical data of patients was collected,indexes related to metabolism and sleep monitoring were recorded,and SPSS27.0 was used to analyze the data.Results:1.Intestinal flora characteristics of patients with different degrees of OSAHS:there was no statistically significant difference in shannon index among the three groups(P>0.05).At the genus level,the relative richness of Coprobacillus in the moderate and severe OSAHS group was significantly lower than that in the control group(P<0.05),while the relative richness of Bacteroides,bifidobacterium,Haemophilus and Klebsiella showed no statistical difference among the three groups(P>0.05).At the species level,the relative richness of Coprofecalis prevoi in mild and moderate to severe OSAHS groups was significantly lower than that in control group,and in moderate to severe OSAHS group was significantly lower than that in mild OSAHS group.The relative richness of bifidobacterium juvenis in moderate to severe OSAHS group was significantly lower than that in control group,with statistical differences(P<0.05).There were no significant differences in the relative richness of bifidobacterium pseudolucidum,bifidobacterium longum,Klebsiella pneumoniae and Haemophilus parainfluenzae among the three groups(P>0.05).2.Levels of inflammatory cytokines in different degrees of OSAHS:There was no statistically significant difference in serum IL-10,IL-6 and CRP among the three groups as a whole(P>0.05).there was significant differences in serum IL-17a and TNF-α among the three groups as a whole(P<0.05).IL-17a in mild OSAHS group and moderate to severe OSAHS group was significantly higher than that in control group(P<0.001),and TNF-α in moderate to severe OSAHS group was significantly higher than that in control group(P<0.05).3.Correlation analysis of intestinal flora richness of OSAHS with cytokines,CRP,polysomnosis monitoring indexes and metabolic indexes:relative richness of Coprofecalis prevotelli was significantly negatively correlated with IL-17a,CRP and AHI(P<0.05),and significantly positively correlated with body mass index(BMI)(P<0.05).The relative abundance of bifidobacterium youth was significantly negatively correlated with IL-17a level(P<0.05),and significantly positively correlated with total cholesterol(TC)(P<0.05).Multiple linear regression analysis showed that AHI and BMI were correlated with relative richness of Coprolitus prevotelli(P<0.05),and IL-17a was correlated with relative richness of Bifidobacterium juvenis(P<0.05).Conclusions:1.Patients with OSAHS have different degree of intestinal flora disorder.There was no significant difference inadiversity of intestinal flora in different degrees of OSAHS,which was mainly reflected in significant differences in relative richness at the genus and species level,and was related to the severity of OSAHS disease.2.The levels of IL-17a,TNF-α and other cytokines showed significant changes in patients with different degrees of OSAHS.3.There is a significant correlation between the relative richness of intestinal flora and cytokine levels,suggesting that the disorder of intestinal flora in patients with OSAHS may be related to chronic systemic inflammation,which may participate in the occurrence and development of OSAHS.