DISTINCTIVE FEATURES OF HORMONAL STATUS IN MALE ADOLESCENTS WITH ESSENTIAL HYPERTENSION AND OBSTRUCTIVE SLEEP APNEA

Abstract

Background. It is known that obstructive sleep apnea (OSA) has been closely linked to essential hypertension (EH) and is considered as an important stressor. The hypothalamic-pituitary-adrenal axis (HPA) is a major component involved in stress response. However, the response of HPA axis to OSA effects may be variable. Aim: to estimate hormonal status in OSA and non-OSA adolescents with EH. Methods. We examined 38 male adolescents with EH (18 OSA patients - group A, 20 non-OSA patients - group B) aged 14-17 years. OSA was verified by polysomnography applying system GRASS-TeLeFACTOR Twin PSG (Comet, USA). EH was diagnosed with 24-h ambulatory blood pressure monitoring using monitor Oscar 2 for OXFORD Medilog Prima. Hormonal status, including thyroid-stimulating hormone (TSH), prolactin (PRL) and cortisol, were routinely collected using an automatic analyzer «Cobos ELL» (USA) and test-system «Alcor-bio» (Russia). All differences were considered significant at p < 0.05. Results. There were statistically significant differences in morning serum cortisol level of OSA adolescents (745.8 ± 6.4 nmol/L versus 493.2 ± 3.2 nmol/L in non-OSA participants; р < 0.05). Morning serum PRL and TSH levels in the both groups no statistically significant differences, but there is a trend towards its increasing in OSA adolescents with EH (482.8 ± 4.2 mME/L in the group A and 442.2 ± 4.1 mME/L in the group B, and 1.95 ± 0.9 mkME/ml versus 1.5 ± 0.2 mkME/ml, respectively, р < 0.05). Conclusion. The results of this study indicate for chronic stress if OSA in adolescents with EH is present. This is due to the influence of sleep fragmentation and intermittent hypoxia on HPA axis with compensatory stress-related hormones release.

Keywords

• adolescents
• hypertension
• hormones
• sleep apnea