Correlation Between Serum Antioxidant Factors And Mild Cognitive Impairment In Patients With OSAHS

Objective:To investigate the association between Obstructive Sleep Apnea Hypopnea Syndrome（OSAHS）with Mild Cognitive Impairment（MCI）and serum levels of the antioxidant factors Albumin（ALB）,Bilirubin（BIL）and Uric Acid（UA）below 380umol/L.Methods:Patients who underwent complete Polysomnography（PSG）between October2021 and June 2022 at the Department of Neurology,the First Affiliated Hospital of Shihezi University School of medicine were selected.Their general data,past history,personal history,blood cell analysis,liver and kidney function,PSG and head CT results were collected.Cognitive function was assessed with the Montreal Cognitive Assessment Scale（Mo CA）as the primary scale.They were grouped according to Apnea Hypopnea Index（AHI）and MOCA score.The data were analyzed using SPSS 25.0,and the data between groups were compared by T test,χ²test,nonparametric rank sum test;Spearman correlation was used for correlation analysis;Multiple linear regression and binary logistic regression were used to evaluate the risk factors;The ROC curve was used to evaluate the predictive value of related antioxidant factors in OSAHS patients with MCI.Results:1.A total of 127 patients were enrolled after screening and divided into 30 healthy controls（no OSAHS and no MCI group）and 97 OSAHS group;Among them,the OSAHS group was divided into the OSAHS without MCI group with 56 patients and the OSAHS with MCI group with 41 patients.2.Comparison of baseline data:compared with the healthy control group,the proportion of men,Body Mass Index（BMI）,Hemoglobin（HGB）,Red Blood Count（RBC）,Hematocrit（HCT）,Direct Bilirubin（DBIL）,AHI,asymptomatic lacunar infarct were higher in the OSAHS group,while the Lowest Oxygen Saturation（LSa O₂）and Mean Oxygen Saturation（MSa O₂）were lower,with statistical differences（P<0.05）;Compared with the group OSAHS without MCI,the group OSAHS with MCI was older,while the education level,HGB,ALB,Indirect Bilirubin（IBIL）,UA below 380umol/L,MSa O₂were lower,with statistical differences（P<0.05）.3.Cognitive impairment in OSAHS patients with MCI was mainly manifested in visual space and executive function,attention,language,abstraction,and delayed recall,with statistical differences（P<0.001）.4.The Mo CA score of OSAHS patients negatively correlated with increasing age（r=-0.613,P<0.001）and positively correlated with increasing of education（r=0.602,P<0.001）,ALB（r=0.297,P=0.003）,IBIL（r=0.311,P=0.002）,UA below 380umol/L（r=0.248,P=0.014）,MSa O₂（r=0.263,P=0.009）.5.Correlation analysis between Mo CA scores of OSAHS patients suggests that:Increased ALB was positively correlated with attention（r=0.369,P<0.001）,abstraction（r=0.285,P=0.005）;Increased IBIL was positively correlated with visual space and executive function（r=0.284,P=0.005）,abstraction（r=0.213,P=0.036）;Increased UA below 380umol/L was positively correlated with language（r=0.221,P=0.030）,abstraction（r=0.312,P=0.002）,delayed recall（r=0.205,P=0.044）;Increased MSa O₂was positively correlated with visual space and executive function（r=0.260,P=0.010）,delayed recall（r=0.311,P=0.002）.6.Multiple linear regression suggested that age（β=-0.596,P<0.001）growth was a negative effect of Mo CA score in OSAHS patients,IBIL（β=0.167,P=0.022）,UA below 380umol/L（β=0.214,P=0.004）、MSa O₂（β=0.135,P=0.048）were positively associated with higher Mo CA scores in OSAHS patients;Binary logistic regression suggested increasing age as a risk factor for comorbid MCI in OSAHS patients（OR=1.220,P<0.001）and increasing IBIL as a protective factor for comorbid MCI in OSAHS patients（OR=0.772,P=0.004）.7.The area under the ROC curve for the combined markers ALB,IBIL and UA below 380umol/L in predicting pooled MCI in patients with OSAHS was 0.715（95%CI:0.610～0.821;P<0.001）,sensitivity is83.90%,specificity is 58.50%.Conclusions:1.Elevations in ALB,IBIL,and UA below 380umol/L may positively correlate with cognitive function in patients with OSAHS.2.Elevations in IBIL and UA below 380umol/L may be positive factors to the Mo CA score of OSAHS patients,where elevated IBIL may be a protective factor in patients with OSAHS complicated with MCI.3.Combined indicators of ALB,IBIL and UA below 380umol/L may have some diagnostic value in patients with OSAHS complicated by MCI or not.