Influence Of Cpap Therapy On The Levels Of Advanced Glycation End Products And Oxidated Low Density Lipoprotein In Patients With Osahs

INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE(2016)

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Abstract
To observe and analyze the effects of continuous positive airway pressure (CPAP) ventilation on advanced glycation end products (AGEs) and oxidized low density lipoprotein (ox-LDL) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), 60 patients with OSAHS were selected as the case group, and 30 patients with simple snoring were selected as the control group. The patients were treated with CPAP for 4 weeks. The serum levels of AGEs and ox-LDL of patients in the control group and of OSAHS patients before and after CPAP treatment were compared. Other clinical indexes were observed and compared including age, body mass index (BMI), waist circumference, neck circumference, insulin level, homeostasis model assessment (HOMA) index, systolic blood pressure (SBP), diastolic blood pressure (DBP), apnea hypopnea index (AHI), and lowest observed oxygen saturation (LSaO2). The serum levels of AGEs and ox-LDL in the case group prior to treatment were significantly higher than those in the control group (t = 6.494, 30.128, P < .05). After CPAP treatment, the serum levels of AGEs and ox-LDL measured in OSAHS patients decreased significantly (t = 18.057, 58.556, P < .05) but were still higher than those in the control group (t = 2.176, 14.156, P < .05). After CPAP treatment, patients in the case group showed significant improvement in insulin (t = 5.198, P < 0.05), HOMA index (t = 6.631, P < 0.05), SBP (t=5.921, P < 0.05), DBP (t = 5.022, P < 0.05), AHI (t = 8.025, P < 0.05) and LSaO2 (t = -12.016, P < 0.05). The AHI level after CPAP treatment of the patients with OSAHS was positively correlated with the patients' BMI (standardized regression coefficient = 0.457), neck circumference (standardized regression coefficient = 0.337), HOMA index after the treatment (standardized regression coefficient = 0.669), SBP level after the treatment (standardized regression coefficient = 0.492), the serum AGE level after the treatment (standardized regression coefficient = 0.651), and the serum ox-LDL level after the treatment (standardized regression coefficient = 0.613; P < .05). LSaO2 was negatively correlated with the patients' BMI (standardized regression coefficient = -0.415), HOMA index after the treatment (standardized regression coefficient = -0.537), SBP level after the treatment (standardized regression coefficient = -0.336), the serum AGE level after the treatment (standardized regression coefficient = -0.528), and the serum ox-LDL level after the treatment (standardized regression coefficient = -0.611; P < .05). In sum, patients with OSAHS show higher serum levels of AGEs and ox-LDL, and the application of CPAP treatment can improve clinical symptoms and reduce the serum AGE and ox-LDL levels of the patients with OSAHS. This reduction may play a role in reducing oxidative stress and regulating metabolism, thereby reducing the risk of cardiovascular and cerebrovascular disease.
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Key words
Continuous positive airway pressure ventilation, obstructive sleep apnea hypopnea syndrome, advanced glycation end products, oxidized low density lipoprotein, curative effect observation
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