Xu Yan, Li Shunwei, Huang Xizhen, Cong Bo
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2002 Oct 25;82(20):1388-90.
To explore the possible biochemical mechanism of cognitive impairment in patients with obstructive sleep apnea syndrome (OSAS).
Polysomnography was administered to thirty-six patients with OSAS and eighteen education and BMI-matched controls, all males aged 40 approximately 49 for 8.5 hours at night. Early next morning blood was drawn and serum insulin-like growth factor-I (IGF-I) was determined by immunoradiometric assay. Then neuropsychological tests of visual regeneration, digital symbol, comprehensive memory and digital span were conducted.
The quality of sleep in the patients with OSAS was significantly worse than that of the controls. The score of visual regeneration in the patients with OSAS was 8.4 +/- 2.7, significantly lower than that in control group (11.6 +/- 1.4, P < 0.01). The score of digital symbol in patients with OSAS was 36.92 +/- 8.31, significantly lower than that in the controls (47.8 +/- 6.8, P < 0.01). The serum IGF-I level of the patients with OSAS was: 127.2 +/- 87.0 ng/ml, significantly lower than that of the controls (194.03 ng/ml +/- 77.31 ng/ml, P < 0.05). The IGF-I level was significantly positively correlated with the scores of visual regeneration test (r = 0.381, P < 0.05) and digital symbol test (r = 0.330, P < 0.05), lowest SaO(2) (r = 0.371, P < 0.05), mean SaO(2) (r = 0.333, P < 0.05) and REM sleep duration (r = 0.598, P < 0.01).
Decrease of serum IGF-I level may play a role in the cognitive impairment in patients with OSAS. Nocturnal hypoxemia and REM sleep deprivation may be the reason of the decrease of the serum IGF-I level in patients with OSAS.
探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者认知功能障碍的可能生化机制。
对36例OSAS患者和18例年龄、体重指数相匹配的对照者(均为40至49岁男性)进行夜间8.5小时的多导睡眠监测。次日清晨采血,采用免疫放射分析法测定血清胰岛素样生长因子-I(IGF-I)。然后进行视觉再生、数字符号、综合记忆和数字广度的神经心理学测试。
OSAS患者的睡眠质量明显差于对照组。OSAS患者的视觉再生得分是8.4±2.7,显著低于对照组(11.6±1.4,P<0.01)。OSAS患者的数字符号得分是36.92±8.31,显著低于对照组(47.8±6.8,P<0.01)。OSAS患者的血清IGF-I水平为:127.2±87.0 ng/ml,显著低于对照组(194.03 ng/ml±77.31 ng/ml,P<0.05)。IGF-I水平与视觉再生测试得分(r = 0.381,P<0.05)、数字符号测试得分(r = 0.330,P<0.05)、最低血氧饱和度(r = 0.371,P<0.05)、平均血氧饱和度(r = 0.333,P<0.05)和快速眼动睡眠持续时间(r = 0.598,P<0.01)显著正相关。
血清IGF-I水平降低可能在OSAS患者的认知功能障碍中起作用。夜间低氧血症和快速眼动睡眠剥夺可能是OSAS患者血清IGF-I水平降低的原因。