高血压合并阻塞性睡眠呼吸暂停低通气综合征患者胰岛功能与氧化应激的关系

Relationship Between Pancreatic Islet Function and Oxidative Stress in Hypertensive Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

目的观察高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者胰岛功能的变化,探讨其变化与氧化应激的关系。方法入选OSAHS患者146例,根据血压水平分为单纯OSAHS组(n=60)和高血压合并OSAHS组(n=86),另入选同期健康体检人群为正常对照组(n=50)。测定各受试者的血糖、血脂、胰岛素等生化指标和血浆丙二醛、总抗氧化能力(TAOC)、红细胞谷胱甘肽(GSH)和超氧化物歧化酶(SOD)的水平。采用稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMAβ)和胰岛素敏感指数(ISI)评价胰岛功能。结果与正常对照组比较,OSAHS组患者的丙二醛水平升高,TAOC、GSH和SOD水平下降,同时空腹血糖、空腹胰岛素(FINS)和HOMA-IR升高,HOMAβ和ISI下降(均P<0.05);与单纯OSAHS组比较,高血压合并OSAHS组上述指标变化更明显(均P<0.05)。Logistic回归分析显示,丙二醛、TAOC、GSH和SOD是胰岛功能受损的影响因素(均P<0.05)。结论高血压合并OSAHS患者胰岛功能的受损可能与氧化应激有关。

Objective To explore the relationship between pancreatic islet function and oxidative stress in hypertensive patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）.Methods One hundred and forty six OSAHS patients were enrolled and divided into OSAHS alone group（n=60） or hypertension with OSAHS group（n=86） according to the level of blood pressure,healthy subjects served as control（n=50）.Serum glucose,lipids,insulin,plasma malondialdehyde（MDA）,total antioxidation capability（TAOC）,erythrocyte reduced glutathione（GSH） and superoxide dismutase（SOD） were determined.Insulin resistance index（HOMA-IR）,insulin secretion index（HOMA β） and insulin sensitivity index（ISI） were calculated.Results The levels of MDA was increased,TAOC,GSH and SOD were decreased,while FBG,FINS and HOMA-IR were higher,HOMA β and ISI were lower in OSAHS patients than those in control group（all P〈0.05）;The changes of these parameters were more significant in hypertensive patients with OSAHS than in OSAHS alone as compared with control group（all P〈0.05）.Logistic regression analysis showed that： MDA,TAOC,GSH,SOD were the impacting factors for impaired pancreatic islet function（P〈0.05）.Conclusion Impaired pancreatic islet function in hypertensive patients with OSAHS relates significantly to oxidative stress.