Abstract:

Objective

To assess the value of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) in the diagnosis and surgical treatment of obstructive sleep apnea-hypopnea syndrome(OSAHS).

Methods

A total of 225 adult OSAHS patients who underwent surgery at the Department of Otorhinolaryngology, Huaian Hospital Affiliated to Xuzhou Medical University from June 2022 to August 2023 were included in this study. The patients were divided into severe, moderate, and mild groups based on the severity of OSAHS. Demographic and clinical data were collected, and serum levels of VEGF and IL-6 were measured preoperatively and one week, six months, and one year post-surgery. Logistic stepwise regression was employed to assess the predictive ability of combined VEGF and IL-6 levels for postoperative improvement. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of these biomarkers.

Results

Patients with severe OSAHS had a significantly higher male-to-female ratio (81.7%, P=0.048) compared to those with mild and moderate OSAHS. Additionally,patients with severe OSAHS exhibited significantly greater median weight [83 kg (75, 90), P=0.023] and neck circumference [42.0 cm (40.0, 45.0), P=0.002]. Preoperative metrics, including the apnea-hypopnea index (AHI), minimum and average oxygen saturation, Stop-Bang score, and Epworth Sleepiness Scale score, showed significant differences among the groups. Postoperatively, VEGF and IL-6 levels in the severe group remained elevated compared to the mild and moderate groups at all time points, demonstrating a strong correlation with OSAHS-related parameters. The area under the ROC curve (AUC) for predicting sixmonth postoperative efficacy was 0.746 for VEGF, 0.781 for IL-6, and 0.787 for the combined model. For predicting one-year postoperative efficacy, the AUC was 0.691 for VEGF, 0.723 for IL-6, and 0.740 for the combined model. Although the severe group experienced a higher incidence of postoperative complications,the difference was not statistically significant.

Conclusion

VEGF and IL-6 are significant biomarkers in assessing the severity and prognosis of OSAHS. The combined use of these biomarkers, alongside clinical indicators, enhances diagnostic accuracy and prognostic precision in the management of OSAHS.

Key words: IL-6, VEGF, obstructive sleep apnea-hypopnea syndrome, Prognostic model