阻塞性睡眠呼吸暂停低通气综合征与肥胖及血清抵抗素水平关系的研究

Study of the relationship between obstructive sleep apnea syndrome and obesity and serum resistin level

目的：了解正常人和阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清抵抗素水平,探讨OS-AHS与肥胖及抵抗素之间的关系。方法：测量35例OSAHS患者（OSAHS组）和40例健康体检者（正常对照组）的身高、体重,计算体质指数（BMI）。根据BMI将35例OSAHS患者分为正常体重亚组（BMI18.5～24.9,14例）和超体重亚组（BMI≥25,21例）。检测血压、空腹血糖（FPG）、总胆固醇（TC）、三酰甘油（TG）及空腹血清抵抗素水平。PSG测定35例OSAHS患者AHI、平均血氧饱和度及最低血氧饱和度。结果：①OSAHS组血清抵抗素水平、BMI、TG、收缩压（SBP）和舒张压（DBP）比正常对照组高,且均差异有统计学意义（均P〈0.05）;②OS-AHS患者中超体重亚组BMI、SBP、DBP、AHI显著高于正常体重亚组（P〈0.05）;③OSAHS组BMI与AHI、SBP正相关,与平均血氧饱和度、最低血氧饱和度负相关;④OSAHS组血清抵抗素水平与FPG、TG、DBP正相关。多元逐步回归结果表明：TG和FPG是影响血清抵抗素水平的重要因素（P〈0.05）。结论：OSAHS患者血清抵抗素水平升高,且存在血压、血脂紊乱,肥胖或腹部肥胖可能加重OSAHS患者缺氧。TG、FPG、DBP与抵抗素正相关,且TG、FPG为影响血清抵抗素水平的重要因素。血清抵抗素水平与OSAHS患者的脂代谢和糖代谢密切相关,并可能与DBP水平有一定联系。

Objective： To investigate the serum resistin level in healthy volunteers and patients with obstructive sleep apnea syndrome（OSAHS）, and study the relationship between OSAHS and obesity, serum resistin level. Method：All body＇s height, weight and calculate body mass index （BMI） were precisely measured. According to the BMI, 35 OSAHS patient were divided into two groups： One group was nomal weight patients （BMI： 18.5-24.9, 14 cases）and the other group was overweight patients（BMI≥25, 21 cases）. There were 40 healthy volunteers in control group. The blood pressure, fasting levels of plasma glucose （FPG）, total cholesterol （TC） and triglyceride （TG）, and test resistin level in plasma were detected. The apnea-hypopnea index （AHI）, the average oxygen saturation and the minimum oxygen saturation in 35 OSAHS patients were examined with Polysomnography. Result： （1）Compared with healthy volunteers, serum resistin level, BMI, TG, systolic blood pressure （SBP） and diastolic blood pressure （DBP） in OSAHS patients were all enhanced （P〈0.05） ; （2）In OSAHS patients, the indexes of BMI, SBP, DBP and AHI for overweight group were notably higher than those for normal weight group （P〈0.05）. （3）In OSAHS patients, BMI was positively correlated with AHI and SBP, and negatively correlated with the average oxygen saturation and the minimum oxygen saturation. （4）Serum resistin level was positively correlated with TG, FPG and DBP. Multiple stepwise regression analysis revealed that serum resistin level was associated with TG and FPG. Conclusion： In OSAHS patients, serum resistin level is enhanced and accompany with the disorder of blood pressure and serum lipid. Obesity or abdomen obesity may aggravate the hypoxia in OSAHS patients. Serum resistin level is positively correlated with TG , FPG and DBP. TG and FPG are important factors in serum resistin level, which indicate that the resistin is highly associated with lipid metabolism and glycometablism, and possibly connect with diastolic blood pressure （DBP）.