阻塞性睡眠呼吸暂停低通气综合征与胰岛素抵抗的相关性

The relationship between obstructive sleep apnea-hypopnea syndrome and insulin resistance

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与胰岛素抵抗(IR)之间的相关性。方法纳入接受多导睡眠监测的OSAHS伴超重患者75例(A组)、OSAHS患者66例(B组)、单纯超重者25例(C组)和健康成人(D组)26名,测定其呼吸暂停及低通气指数(AHI)、最低血氧饱和度(miniSpO2)值、空腹血糖值、空腹胰岛素值,并计算其胰岛素敏感指数(ISI)。结果ISI均值A组为-4.8±0.7,B组为-4.5±0.4,C组为-4.0±0.3,D组为-4.50±0.3。与D组比较,A组、B组和C组的ISI均值皆显著降低(均P<0.05);与C组比较,A组的ISI均值显著降低(P<0.05)。A组患者及B组患者的ISI与AHI之间均呈负相关(r=-0.352,P<0.01;r=-0.267,P<0.05),其ISI与miniSpO2之间均呈正相关(r=0.379,P<0.01;r=0.314,P<0.05)。结论OSAHS患者体内存在着明显的IR,这种IR与超重、AHI和miniSpO2明显相关。

Objective To explore the relationship between obstructive sleep apnea-hypopnea syndrome OSAHS and insulin resistance IR. Methods All subjects enrolled in this study were divided into 4 groups group A-75 OSAHS patients with overweight group B- 66 OSAHS patients without overweight group C- 25 patients with overweight and group D-26 healthy adults. The values of apnea hypopnea index AHI minimal pulse oxygen saturation miniSpO2 fasting plasma glucose and fasting insulin were measured and the insulin sensitive index ISI was calculated in all subjects. Results The average values of ISI in group A -4.8±0.7 group B -4.5±0.4 and group C -4.5±0.3 were decreased significantly compared with that in group D -4.0±0.3 all P<0.05. Compared with group C the average value of ISI in the group A was significantly decreased P<0.05. There was a negative correlation between ISI and AHI in group A and group B(r=-0.352,P <0.01;r=-0.267,P<0.05 respectively)and a positive correlation between ISI and miniSpO2(r=0.379,P<0.01;r=0.314, P<0.05 respectively ) in group A and group B. Conclusion OSAHS patients have insulin resistance which is closely associated with overweight apnea hypopnea index and minimal pulse oxygen saturation.