老年阻塞性睡眠呼吸暂停综合征患者血清脂联素、抵抗素的变化及其与胰岛素抵抗的相关性

Relationship between serum adiponectin and resistin in old patients with obstructive sleep apnea syndrome with insulin resistance

目的探讨血清脂联素、抵抗素水平在老年阻塞性睡眠呼吸暂停综合征(OSAS)患者体内的变化及其与胰岛素抵抗(IR)的关系。方法选择体重指数(BM I)相匹配的老年OSAS患者60例(OSAS组)和单纯肥胖者40例(健康对照组),用多导睡眠呼吸监测仪进行监测,分别采用免疫放射分析法(IRMA)、酶联免疫分析法(ELISA)测定所有研究对象血清脂联素、抵抗素水平,并检测所有受试者的血压、空腹血糖(FPG)、空腹胰岛素(FINS)、血脂。采用稳态模型法(HOMA)计算IR指数(HOMA-IR)。结果 OSAS组的甘油三酯(TG)、FINS、HOMA-IR、抵抗素水平显著高于健康对照组(P<0.05),高密度脂蛋白(HDL)、脂联素水平显著低于对照组(P<0.05或P<0.01)。多元逐步回归分析显示:FPG、BM I、呼吸暂停低通气指数、脂联素、抵抗素是影响OSAS患者IR的独立危险因素。结论老年OSAS患者存在IR,随着OSAHS病情的加重,IR进一步加重,脂联素、抵抗素可能影响OSAS患者IR的程度。

Objective To study the changes of serum adiponectin and resistin levels in old patients with obstructive sleep apnea syndrome（OSAS） and the relationship of adiponectin and resistin with insulin resistance（IR）.Methods Polysomnography was performed in 60 OSAS patients（OSAS group） and in 40 simple obese patients（control group） without differences in age and body mass index（BMI）.The levels of fasting blood glucose（FBG）,insulin,lipid,adiponectin and resistin were measured.Serum adiponectin levels were measured by radioimmunoassy and serum resistin levels were measured by ELISA.IR was calculated by homeostasis assessment（HOMA）.Results The levels of triglyceride（TG）,fasting insulin （FINS）,resistin and HOMA-IR in OSAS patients were significantly higher（P0.05） and the high density lipoprotein（HDL）,adiponectin level in these population was significantly lower（P0.05 or P0.01） than that of normal control.FBG,BMI,apnea hypopnea index,adiponectin and resistin were independent risk factors affecting IR in OSAS patients.Conclusions OSAS patients exist IR.With the deterioration of OSAS,IR is aggravated.Adiponectin and resistin may affect the IR of OSAS patients.