Objective: To discuss the influence of chronic intermittent hypoxia and secundum oxidative stress on insulin resistance and the function of Pancreatic beta cells in OSAHS patients.
Methods: 15 patients with primary snoring, 31 patients with light to moderate OSAHS and 34 patients with severe OSAHS were investigated. General clinical data of every patient were collected, while nocturnal data were gained by using PSG with entire night monitor. 8-isoprostane and fasting insulin (FINS) were detected through ELISA; GSH-Px through Spectrophotometer. Insulin resistance was evaluated by measuring HOMA-IR and FINS, while the function of Pancreatic beta cells by HOMA-beta. The comparison among the three groups were used by the non-parametric Kruskal-Wallis H test, and Nemenyi test was used for pairwise comparison. The relativity between the variables were assessed by Spearman correlation test, and multiple linear regression was used to remove interference between variables. The enumeration data were compared with chi2 test.
Results: 1. Along with the aggravation of OSAHS, the three groups were statistically different from each other on 8-isoprostane, GSH-Px, fasting blood glucose (FBG), FINS, and HOMA-IR (P=0.0034, P<0.0001), but not on HOMA-beta (P>0.05). 2. ODI, CT90%, lowest SaO2 and mean SaO2 were correlated with FINS and HOMA-IR in the serum, while the coefficient of correlation r decreased from ODI to mean SaO2. After ruling out the influence of age, BMI by multiple linear regression, ODI, CT90% and lowest SaO2 still correlated with FINS and HOMA-IR, the standardized regression coefficient R diminished from ODI, CT90% to lowest SaO2. 3. 8-isoprostane and GSH-Px correlated with FINS and HOMA-IR in OSAHS patients (P<0.05). After eliminated the influence of age, BMI by multiple linear regression, 8-isoprostane still correlated with FINS and HOMA-IR. 4. HOMA-beta has no correlation with AHI, BMI, ODI, CT90%, lowest SaO2, mean SaO2, 8-isoprostane and GSH-Px (P>0.05).
Conclusion: 1. Chronic intermittent hypoxia of OSAHS was independently correlated with IR. Compared with the severity of hypoxia, the insulin resistance has a closer relation with oxygen desaturation index. 2. Secundum oxidative stress in OSAHS was independently correlated with IR. 3. We didn't find the function of Pancreatic beta cells correlating with chronic intermittent hypoxia and secundum oxidative stress.