持续气道正压通气对合并2型糖尿病的OSAHS患者胰岛素抵抗的影响

Effects of continuous positive airway pressure treatment on insulin resistance in patients with type 2 diabetes and obstructive sleep apnea hypopnea syndrome

目的:通过观察了持续气道正压通气(CPAP)治疗对合并2型-糖尿病(2型-DM)的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的胰岛素抵抗(IR)的影响,以验证OSAHS是否为引起糖尿病患者IR增加的独立危险因素。方法:选择25例合并2型-DM的肥胖OSAHS患者,将他们的呼吸暂停/低通气指数(AHI)为37.7±18.0;体重指数(BMI)被控制在29.1±2.3kg/m2;通过6个月的CPAP治疗观察治疗前后反映IR的稳态模式评估(HOMA)指数变化。结果:在BMI无明显改变的情况下,6个月的CPAP治疗后HOMA指数较治疗前明显降低(1.84±1.98vs3.33±2.96,P<0.0001)。结论:CPAP治疗可显著改善OSAHS患者的IR增高,提示OSAHS是IR的独立危险因素。

Objective： To investigate the effects of continuous positive airway pressure （CPAP） treatment on insulin resistance （IR） in patients with type 2 diabetes and obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods：Twenty-five patients with type 2 diabetes and OSAHS were recruited. Their apnea hypopnea index （AHI） was 37.7±18.0 with BMI maintained at 29.1 ± 2.3 kg/m^2. The homeostasis model assessment （HOMA） index was used to reflect IR and measured before and after 6 months＇ CPAP treatment. Results：The HOMA index was significantly lower following 6 months＇ CPAP treatment than before treatment （ 1.84 ± 1.98 vs 3.33 ± 2.96, P 〈 0.0001）. Conclusion：CPAP treatment can significantly improved increased IR in OSAHS patients, which suggests that OSAS is an independent risk factor of IR.