汉族和维吾尔族阻塞性睡眠呼吸暂停低通气综合征患者2型糖尿病患病调查

Correlation between obstructive sleep apnea-hypopnea syndrome and type 2 diabetes mellitus of Han nationality and Uygur nationality

目的 调查35岁以上汉、维吾尔族自然人群阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者2型糖尿病（T2DM）的患病率,探讨OSAHS与T2DM的关系.方法 2010年至2012年间,对克拉玛依市区天山社区755例35岁以上（汉族398例,维吾尔族357例）鼾症患者进行睡眠呼吸血氧监测（呼吸暂停低通气指数,氧减饱和度指数,夜间平均血氧饱和度,夜间最低血氧饱和度）和空腹血糖测定.按睡眠监测结果分为汉族OSAHS组（279例）和维吾尔族OSAHS组（226例）,两组年龄、性别匹配,组间进行各项参数比较.体检项目包括身高、体重、颈围、腰围.结果 汉族与维吾尔族鼾症组间BMI分别为（24.9±3.2）和（28.2± 4.4） kg/m2,颈围分别为（35.2±3.2）和（37.4±3.4）cm,腰围分别为（87.1±9.5）和（98.0±11.6）cm,氧减饱和度指数分别为（9.9±0.5）和（8.2±0.4）次/h,夜间最低血氧饱和度分别为（83.3±6.9）％和（82.7±7.4）％,呼吸暂停低通气指数分别为（15.0±14.3）和（11.9±11.4）次/h,空腹血糖分别为（6.3±1.4）和（7.1±2.8）mmol/L,组间比较差异均有统计学意义（P＜0.05）.维吾尔族与汉族OSAHS组间T2DM患病率[30.5％（69/226）和16.8％ （47/279）]差异有统计学意义（P＜0.05）.多因素logistic回归分析显示,年龄（OR=1.667）、呼吸紊乱指数（OR=2.074）和民族（OR=1.922）是T2DM患病的主要危险因素.结论 维吾尔族OSAHS患者T2DM患病率高于汉族,年龄、民族、呼吸暂停低通气指数是T2DM的患病高危因素,T2DM与OSAHS相关.

Objective To explore the prevalence of diabetes in obstructive sleep apnea-hypopnea syndrome （OSAHS） adults over 35 years old of Han and Uygur nationalities and elucidate the relationship between sleep apnea and type 2 diabetes mellitus.Methods From 2010 to 2012,A total of 755 subjects aged ≥35 years （Han,n =398; Uygur,n =357） were selected from a natural population in Tianshan District of Kelamayi,Xinjiang Autonomous Region.Height,weight,neck circumference,abdominal circumference and blood sugar were measured.And all subjects of snoring underwent respiration and pulse oximeter tests.Apnea-hypopnea index （AHI）,mean SaO2 （MSaO2 ％）,lowest SaO2 （LSaO2 ％） and the number of desaturations ≥4％ per hour （ODI4） were calculated.They were divided into OSAHS and non OSAHS groups.Both Han nationality and Uygur nationality groups were matched for age and gender.Results The parameters of body mass [（24.9 ± 3.2） vs.（28.2 ± 4.4） kg/m2],neck circumference [（35.2 ± 3.2） vs.（37.4 ± 3.4） cm],abdominal circumference [（87.1 ± 9.5） vs.（98.0 ± 11.6） cm],oxygen desaturation index [（9.9 ±0.5） vs.（8.2 ± 0.4）/h],nadir arterial oxygen saturation [（83.3 ±6.9） ％ vs.（82.7 ± 7.4） ％],apnea-hypopnea index [（15.0 ± 14.3） vs.（11.9 ± 11.4）/h] and blood sugar [（6.3 ± 1.4） vs.（7.1 ± 2.8） mmol/L] were significantly different between Han and Uygur nationality snoring groups （P ＜ 0.05）.Significant difference existed in the prevalence of diabetes in OSAHS groups between Han and Uygur nationalities [16.8％ （47/279） vs.30.5％ （69/226）] （P ＜ 0.05）.Logistic regression analysis revealed that age （OR =1.667）,apnea-hypopnea index （AHI） （OR =2.074） and nationality （OR =1.922） were major risk factors for diabetes.The prevalence of diabetes for OSAHS was 19.3％ （69/357） in Uygur nationality versus 11.8％ （47/398） in Han nationality.Conclusion The prevalence of diabetes for OSAHS in Uygur nationality is higher than that in Han nationality.The high-risk diabetic factors are age,nationality and AHI.And a close relationship exists between type 2 diabetes mellitus and sleep apnea.