Plasma estrogen level and estrogen receptors expression in palatine tonsils in male patients with obstructive sleep apnea hypopnea syndrome

Abstract

To detect the plasma estrogen level and estrogen receptors expression in palatine tonsils of male patients with obstructive sleep apnea hypopnea syndrom (OSAHS). Seventy-six patients with OSAHS were selected as experimental group, 45 patients with chronic tonsillitis as the control group. The tonsils and adipose tissues in space veli palatin were surgically resected in the experimental group, the tonsils were resected in the control group. The plasma level of estrogen was evaluated in patients of the two groups with chemiluminescence immunoassay respectively. The expression of estrogen receptors (ER alpha, ER beta) in palatine tonsils was detected with immunohistochemical methods in the two groups. The relationships between the expression of estrogen receptors and the patient's age, history of snoring, history of apnea, apnea hypopnea index (AHI), body mass index (BMI), neck circumference, abdominal circumference, blood pressure, smoking, alcohol drinking, the degree of velopharyngeal stenosis, the Epworth sleepiness scale score (ESS), and accompanied systemic diseases were analyzed. The estradiol levels did not show significant statistical difference between the two groups [(94.94 ± 25.54)pmol/L, (104.23 ± 34.75)pmol/L, respectively]. The estrogen levels in OSAHS patients were positively correlated with the patients' AHI (r = 0.76, P < 0.01), showed positively correlated trends with BMI (r = 0.43, P < 0.01), ESS (r = 0.34, P < 0.01), neck circumference (r = 0.31, P = 0.01), abdominal circumference (r = 0.32, P < 0.01); the expressions of ER alpha and ER beta in the experimental group (36.8%, 48.7%) were lower than that in the control group (60.0%, 68.9%) respectively, the difference was statistically significant (χ(2) were 5.17 and 4.69, P < 0.05); the expressions of ER alpha and beta in OSAHS patients showed negatively correlated trends with the patients' AHI (r = -0.48, P < 0.01; r = -0.26, P < 0.05). The expressions of ER alpha in OSAHS patients showed positively correlated trends with the patients' lowest oxygen saturation. Estrogen may promote the occurrence of male OSAHS. The ER expression in palatine tonsils of male OSAHS patients accorded to the severity of illness, may be associated with hypoxia.