摘要
目的 探讨阻塞性睡眠呼吸暂停低通气综合征（0SAHS）与胰岛素抵抗（IR）的相关性及其可能的发病机制。方法 82例打鼾者根据多导睡眠图检查结果分为：OSAHS组42例，均为中、重度患者（AHI〉20）；对照组40例，两组年龄、性别、血压相匹配。比较两组一般资料（年龄、性别、体质量指数、呼吸紊乱指数、最低血氧饱和度）、血清指标[空腹血糖、空腹胰岛素、胰岛素敏感指数、甘油三脂、胆固醇、脂蛋白a（LPa）、尿酸]，并作统计学分析。结果 一般资料比较：体质量指数、呼吸紊乱指数、最低血氧饱和度组间差异有统计学意义；血清指标比较：除LPa外，其余各项组间差异均有统计学意义。卡方检验显示两组糖尿病的发病率差异有统计学意义。相关分析显示OSAHS组呼吸紊乱指数与胰岛素敏感指数呈显著负相关（r=-0．415，P=0．006），与空腹胰岛素呈显著正相关（r=0．402，P=0．008）。在控制多个变量的影响后，逐步回归分析显示呼吸紊乱指数与体重指数对胰岛素敏感指数具有显著性影响。结论 中、重度OSAHS患者胰岛素敏感性下降，存在IR，两者呈独立相关关系。OSAHS与肥胖、糖耐量低减、高血压、高甘油三脂共同为IR的重要致病因素。
Objective To investigate the association between obstructive sleep apnea hypopnea syndrome （OSAHS） and insulin resistance （IR） and the possible pathogenesis of IR in OSAHS. Methods Based on the results of polysomnography, 82 subjects were divided into control group [apnea hypopnea index （AHD〈5,40 cases] and OSAHS group（AHI〉20,42 cases）. There were no significances in age, gender and blood pressure between two groups. Comparison and statistical analysis between the two groups were made concerning general condition （age, body mass index, AHI, minimal SaO2 ） and blood parameters （fasting blood glucose, fasting blood insulin, insulin sensitivity index, triglyceride, cholesterol, lipid protein and uric acid）. Results There were significant differences in body mass index,AHI,and minimal SaO2 between two groups. Significant differences between two groups were shown in all blood parameters except lipid proteina. Chi square test showed that the incidence of diabetes was significantly different between two groups. In OSAHS group, correlation analysis displayed significant negative correlation between AHI and insulin sensitivity（ r = -0. 415, P =0. 006） ,and positive correlation between AHI and fasting blood insulin. After controlling of several variables, stepwise regression analysis showed that AHI and body mass index had a significant effect on insulin sensitivity. Conclusions In patients with moderate or severe OSAHS, declined insulin sensitivity declines, and IR exists, both are independently correlates. OSAHS, obesity, low insulin resistance,hypertention and high triglyceride all constitute important etiological factors of IR.
出处
《国际呼吸杂志》
2007年第5期321-323,共3页
International Journal of Respiration
