睡眠呼吸暂停综合征对老年患者糖脂代谢水平及肾功能的影响

Effects of sleep apnea syndrome on glucos,lipid metabolism and kideney function in elderly patients

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)对老年患者血糖、血脂代谢水平及肾功能的影响。方法选择OSAS患者60例为观察组,并根据呼吸暂停低通气指数(AHI)分为3个亚组,其中15次/h>AHI≥5次/h 30例为轻度组,30次/h>AHI≥15次/h 17例为中度组,AHI≥30次/h 13例为重度组,选择同期非OSAS患者21例为对照组。比较和分析各组的空腹血糖(FPG)、糖化血清蛋白(GSP)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、尿素氮(BUN)、肌酐(SCr),估算肾小球滤过率(eGFR)、体质量指数(BMI)。结果 BMI、GSP、TC、LDL-C水平在OSAS组高于对照组,中重度组高于轻度组(P<0.05或P<0.01);并与AHI、呼吸暂停指数(AI)呈正相关,FPG、BMI与夜间最低血氧饱和度(LO2)、夜间平均血氧饱和度(AO2)呈负相关;eGFR水平在OSAS重度组低于轻度组,并显著低于对照组(P<0.05或P<0.01);eGFR与AHI呈负相关,与LO2、AO2呈正相关;UA则与LO2、AO2呈负相关。结论 OSAS可致老年患者血糖、血脂代谢异常,加重肾功能损害,也是肥胖的危险因素之一。

Objective To investigate effects of obstructive sleep apnea syndrome （OSAS） on glucose,lipid metabolism and kideney function in elderly patients. Methods 60 patients with OSAS were divided into three sub- groups according to apnea-hypopnca index （AHI）, 30 patients with 15 times/h 〉 AHI ≥5 times/h in the mild sub- group,17 patients with 30 times/h 〉 AHI ≥ 15 times/h in the moderate subgroup, and 13 patients with AHI ≥ 30 times/h in the severe subgroup. At the same time ,21 patients without OSAS were selected as control group. And all 13 indexes were compared and analyzed, such as fasting blood glucose （FBG）, glycosyloted serum protein （GSP）, total cholesterol （ TC ） , low density lipoprotein cholesterol （ LDL-C ） , uric acid （ UA ） , blood urea nitrogen （ BUN ） , serum creatinine （SCr）, glomerular filtration rate （eGFR） and body mass index （BMI）. Results The levels of BMI, GSP, TC and LDL-C in OSAS group were higher than those in the control group, and those in the moderate subgroup were higher than those in the mild subgroup （P 〈 0.05 or P 〈 0. 01 ）, and they were positive correlative with AHI and AI, FPG and BMI were negative correlative with LO^and AO~ ;the level of eGFR in OSAS severe group was lower than that in the mild subgroup, and significant lower than that in the control group （ P 〈 0.05 or P 〈 0. 01 ） ; eGFR was negtive correlative with AHI, but positive correlative with LO2 and AO2 ; Serum UA was positive correlative with AHI, but neg- tive correlative with LO2 and AO2. Conclusion OSAS can cause abnormal metabolism of blood glucose and lipid,de- crease kideney function in elderly patients and is one of the risk factor of fatness.