The Correlation Between Serum AGEs,TLR4 Levels And Mild Cognitive Impairment In Patients With OSAHS

Objective:By detecting the levels of serum advanced glycation end products(AGEs)and toll-like receptors 4(TLR4)in patients with obstructive sleep apnea-hypopnea syndrome,to analyze the correlation between serum AGEs and TLR4 levels and mild cognitive impairment(MCI),to explore clinical application value.Methods:89 patients diagnosed with adult OSAHS in our hospital from September 2021 to December 2022 were selected as research subjects,including 23 patients with mild to moderate OSAHS and 66 patients with severe OSAHS.All patients filled in the Montreal Cognitive Assessment(Mo CA Scale)on the day of overnight polysomnography(PSG)for cognitive function assessment,and divided them into OSAHS cognitive normal group(OSAHS group)and OSAHS mild cognitive impairment group(OSAHS-MCI group),and fasting venous blood was drawn early the next morning.we used ELISA method to detect serum AGEs and TLR4 levels.Results:1.Mo CA evaluation of OSAHS patientsAmong the 89 OSAHS patients,44 patients were normal cognition with a Mo CA score of ≥ 26 points,and 45 patients were mild cognitive impairment with a Mo CA score of<26 points.OSAHS combined with MCI patients accounted for 50.56% of the total study subjects.Among them,scores of delayed recall,abstract,visuospatial abilities and executive function were low.2.Comparison of General information among groups2.1 There were no significant difference in gender,age,education level,body mass index(BMI),smoking history,and comorbidities(hypertension,hyperlipidemia,coronary heart disease)between OSAHS and OSAHS-MCI groups(P>0.05).2.2 There were no significant difference in gender,age,education level,body mass index(BMI),smoking history,and comorbidities(hypertension,hyperlipidemia,coronary heart disease)between the mild to moderate OSAHS group and the severe OSAHS group(P>0.05).3.Comparison of serum AGEs and TLR4 levels among groups3.1 Compared with the OSAHS group,the serum AGEs level was higher in OSAHS-MCI group,but the difference was not statistically significant(P>0.05).Compared with the OSAHS group,the serum TLR4 level was elevated in the OSAHS-MCI group with a statistically significant difference(P<0.05).3.2 Compared with the mild to moderate OSAHS group,the serum AGEs level of severe OSAHS group was lower,but the difference was no statistical significance(P>0.05),and compared with the mild to moderate OSAHS group,the serum TLR4 level in the severe OSAHS group was higher and the difference was statistically significant(P<0.05).4.Correlation analysis of serum AGEs and TLR4 levels with Mo CA score and subcognitive domain score in OSAHS patientsSpearman correlation analysis showed that there was no correlation between serum AGEs levels and Mo CA score and subcognitive domain score in OSAHS patients(P > 0.05),and serum TLR4 levels were negatively correlated with Mo CA score,visuospatial abilities and executive function,attention,abstract,and delayed recall(r=-0.404,P=0.000;r=-0.307,P=0.003;r=-0.339,P=0.001;r=-0.222,P= 0.036;r=-0.405,P=0.000),no correlation with naming,language,orientation(P>0.05).Conclusions:1.OSAHS patients may be prone to mild cognitive impairment.2.The occurrence of mild cognitive impairment in OSAHS patients was not associated with the levels of AGEs in the serum in this study,which requires further study.3.Elevated serum TLR4 levels may be associated with the development and progression of mild cognitive impairment in OSAHS patients.4.The measurement of serum TLR4 levels may be used to assess some of the cognitive functions of patients with OSAHS.