阻塞性睡眠呼吸暂停低通气综合征患者的胰岛素抵抗现象

Insulin resistance in patients with obstructive sleep apnea-hypopnea syndrome

目的:了解阻塞性睡眠呼吸暂停低通气综合征与胰岛素抵抗之间的关系及经鼻持续气道正压通气对胰岛素抵抗的影响。资料来源:应用计算机检索Medline 2004-01/2006-12相关文章,检索词“obstructive sleep apnea-hypopnea syndrome,insulin resistance CPAP”,并限定文章语言种类为English。同时计算机检索万方数据库2000-01/2006-12期间的相关文章,限定文章语言种类为中文,检索词“阻塞性睡眠呼吸暂停低通气综合征,胰岛素抵抗,经鼻持续气道正压通气”。资料选择:对资料进行初审,选取有关阻塞性睡眠呼吸暂停低通气综合征和胰岛素抵抗的文献,纳入标准:①文献能证明二者之间的关系。②治疗组为阻塞性睡眠呼吸暂停低通气综合征组。③对照组为正常人。④经鼻持续气道正压通气治疗前后空腹胰岛素水平和胰岛素敏感指数的变化。资料提炼:共收集到35篇有关阻塞性睡眠呼吸暂停低通气综合征和胰岛素抵抗的文章,33篇符合纳入标准。排除的2篇试验中,皆因系重复的同一研究。资料综合:对剩余的33篇文献全文中的相关信息进行分类综合研究。治疗组空腹胰岛素较对照组高,胰岛素敏感指数降低,在治疗后空腹胰岛素水平降低,而胰岛素敏感指数提高。结论:阻塞性睡眠呼吸暂停低通气综合征与胰岛素抵抗之间有着显著的相关关系,经经鼻持续气道正压通气治疗可提高患者的胰岛素敏感性,改善患者的胰岛素抵抗现象。

OBJECTIVE： To study the relationship between obstructive sleep apnea-hypopnea syndrome and insulin resistance, and the impact of continuous positive airway pressure （CPAP） to insulin resistance. DATA SOURCES： Using the key words of ＂obstructive sleep apnea-hypopnea syndrome, insulin resistance, CPAP＂, we searched the Medline database for related articles published in English from January 2004 to December 2006. Meanwhile, we searched the Wanfang database for related articles published in Chinese between January 2000 and December 2006 with the same key words in Chinese. STUDY SELECTION： The data were preliminarily selected to choose those about obstructive sleep apnea-hypopnea syndrome and insulin resistance. Inclusive criteria： （1）about the relationship between obstructive sleep apnea-hypopnea syndrome and insulin resistance; （2）therapeutic group has OSAHS; （3）normal subjects serve as the normal control group; （4）fasting plasma insulin and insulin sensitivity index were compared before and after CPAP treatment. DATA EXTRACTION： There were 35 literatures about the obstructive sleep apnea-hypopnea syndrome and insulin resistance, and 33 were in accordance with the above-mentioned criteria. Two repetitive experiments were excluded. DATA SYNTHESIS： The related information of the rest 33 articles were arranged and analyzed. The fasting plasma insulin of the obstructive sleep apnea-hypopnea syndrome group was higher than the control group, and the insulin sensitivity index was lower, but after treatment, the fasting plasma insulin was decreased and insulin sensitivity index was elevated. CONCLUSION： There is significant correlation between obstructive sleep apnea-hypopnea syndrome and insulin resistance. CPAP treatment could improve the insulin sensitivity and insulin resistance condition of the patients.