阻塞性睡眠呼吸暂停综合征与胰岛素抵抗的临床研究

Clinical Research on obstructive sleep apnea syndrome and insulin resistance

目的探讨阻塞型睡眠呼吸暂停综合征(OSAS)与胰岛素抵抗(IR)之间的关系。方法56例OSAS患者,按低氧血症的程度分为两组,监测多导睡眠图各项指标与空腹血糖、胰岛素和餐后2h血糖、胰岛素,计算胰岛素敏感性指数(ISI),并作统计学分析。另外选择15例不符合OSAS诊断者为对照组。结果OSAS患者较对照组血浆胰岛素、血糖升高,与呼吸暂停低通气指数(AHI)、最长睡眠呼吸暂停时间(SAT)和总睡眠呼吸暂停时间呈正相关。随着缺氧程度的加重,ISI逐渐降低,胰岛素抵抗增加。在OSAS组血糖、胰岛素和ISI影响因素的多元线性回归分析中,总睡眠呼吸暂停时间的贡献度最大。结论OSAS与IR之间存在相关性,OSAS低氧可产生胰岛素抵抗。

Objective To observe the correlation between OSAS and insulin resistance. Methods Based on the degree of hypoxemia,56 OSAS patients were divided into two groups. All the index of polysomnography, fasting plasma insulin, fasting plasma glucose,insulin and blood suger of 2 hours after meal were monitored, calculated insulin sensitivity index（ISI）. The other 15 eases of non-OSAS were selected as control group. Results Plasma glucose and insulin increased markedly in OSAS patients. With the reduction of oxygen saturation, ISI reduced and insulin resistance increased. Multiple linear regression showed that totle sleep apnea time（SAT） was the major determinant of IR in the OSAS group. Conclusion OSAS was significantly associated with IR. OSAS hypoxemia may develop IR.