OSAS患者血清同型半胱氨酸水平与胰岛素抵抗及其相互关系

Serum homocysteine levels,insulin resistance and their relationship in patients with obstructive sleep apnea syndrome(OSAS)

目的通过观察OSAS患者血清同型半胱氨酸(Hcy)及胰岛素抵抗水平,分析两者之间的关系,进一步探讨OSAS患者高同型半胱氨酸血症及脑梗死发生的可能机制。方法按照便携式睡眠呼吸监测仪的监测数据,将入选者分为OSAS组(n=42)与对照组(n=40),检测入选者空腹血清Hcy、血糖、血清胰岛素水平,计算出胰岛素抵抗指数(HOMA-IR);比较2组血清Hcy、HOMA-IR水平,探讨血清Hcy与HO-MA-IR的关系。结果 OSAS组的血清Hcy、HOMA-IR水平较对照组显著增高(P<0.05),血清Hcy与HOMA-IR呈正相关(r=0.815,P<0.01),经偏相关分析校正体重指数及年龄的影响后它们之间仍呈正相关(r'=0.715,P<0.01)。结论 OSAS可能通过胰岛素抵抗的增强而影响Hcy的代谢,引起高同型半胱氨酸血症,进而导致脑梗死的发生。

Objective To observe the levels of insulin Homocysteinemia（Hcy） and resistance in patients with OSAS,and analysis the relationship between them;To explore the possible mechanism of cerebral infarction in OSAS patients with hyperhomocysteinemia. Methods The participants were divided into the OSAS group（n=42） and the controll group（n=40） according to the results of portable polysomnography.The fasting serum Hcy,glucose,insulin and lipids were detected.Then we compared the levels of Hcy and HOMA-IR between two groups and analysis the relationship between Hcy and apnea hypopnea index（AHI）,Hcy and HOMA-IR. Results Hcy and HOMA-IR levels in OSAS group were higher than the controls（P0.05）.Hcy was positively correlated with HOMA-IR and AHI in OSAS group（r=0.815,P0.01）.The positive correlations between them remained significant after revising BMI and age by partial correlation analysis（r＇=0.715,P0.01）. Conclusions OSAS may affect the metabolism of Hcy,and result in hyperhomocysteinemia by causing insulin resistance,and then HHcy causes cerebral infarction.