持续气道正压通气治疗2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征对患者内分泌功能的影响研究

Effect of CPAP therapy on endocrine function in patients with type 2 diabetes complicated by obstructive sleep apnea-hypopnea syndrome

目的探讨持续气道正压通气(CPAP)治疗合并有阻塞性睡眠呼吸暂停低通气综合征(OS-AHS)的2型糖尿病(T2DM)对患者内分泌功能的影响。方法选取2008年7月至2009年12月于卫生部北京医院内分泌科确诊合并有OSAHS的2型糖尿病患者36例。对无禁忌者应用至少30d的CPAP治疗。在治疗前后对受试患者进行空腹血糖、空腹胰岛素、甲状腺激素、生长激素、促肾上腺皮质激素、皮质醇及性腺激素水平的检测。结果受试患者应用CPAP治疗前后的胰岛素敏感性增加(P=0.034),催乳素(PRL)及雌二醇(E2)治疗后较治疗前明显降低(P分别为0.016、0.013),余激素水平无明显变化(P>0.05)。结论 CPAP治疗可以改善合并OSAHS的2型糖尿病患者的胰岛素抵抗,但是对于该类患者的其他内分泌激素水平没有明显影响。

Objective To investigate the effect of continuous positive airway pressure（CPAP） treatment on endocrine function in patients with type 2 diabetes complicated by obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods 36 patients with T2DM and newly diagnosed OSAHS were treated by CPAP for at least 30 days. Subsequently, the data of fasting blood glucose, insulin, thyroid hormone, growth hormone, adrenocorticotropic hormone,cortisol and sex hormone were rechecked and compared to those previously achieved. Results After the application of CPAP treatment, the homeostasis model assessment （HOMA） index of insulin resistance was significantly lower than before （ P = 0. 034 ） ; the prolaetin （PRL） and estradiol （ E2 ） levels were significantly lower （ P = 0. 016,P = 0. 013 ）, without significant changes in other hormone levels （ P 〉 0.05 ）. Conclusion CPAP treatment can be an effective method for improving the insulin sensitivity of the type 2 diabetes patients complicated by OSAHS, but has no significant effect on other endocrine function in these patients.