阻塞性睡眠呼吸暂停患者血清瘦素水平的研究

Study of serum leptin level in patients with obstructive sleep apnea

目的 探讨瘦素在阻塞性睡眠呼吸暂停综合征 (OSAS)患者体内的变化。方法 选择年龄及体重指数 (BMI)差异无显著性的OSAS患者 5 8例和单纯肥胖者 2 1例 ,用多导睡眠呼吸监测仪进行监测 ,用放射免疫法测定所有对象的血清瘦素。结果 (1)无论男性还是女性 ,OSAS患者瘦素水平 [(6 1± 1 7) μg/L ,(19 5± 9 9) μg/L]平均高于单纯肥胖者 [(4 5± 1 7) μg/L ,(10 5± 2 4) μg/L](P <0 0 1,P <0 0 5 )。 (2 )单纯肥胖者及OSAS患者血清瘦素水平分别与BMI呈显著正相关 (r=0 5 9,P <0 0 1;r=0 6 4,P <0 0 1) ,同时OSAS患者血清瘦素水平分别与呼吸暂停及低通气指数 (AHI) (r=0 47,P <0 0 1)和颈围 (r=0 6 4,P <0 0 1)也有明显的正相关。结论 OSAS患者血清瘦素水平比单纯肥胖者更高 ,除了肥胖、颈围宽外 ,OSAS本身也是引起瘦素水平升高的原因。

Objective To explore the change of serum leptin in patients with obstructive sleep apnea syndrome (OSAS). Methods Polysomnography was performed in 58 patients with OSAS and in 21 simple obese controls without differences in age and body mass index (BMI). Serum leptin level was measured by radioimmunoassay. Results (1)The serum leptin level in patients with OSAS was higher, in both males (6.1±1.7) μg/L and females(19.5±9.9) μg/L, than that in the simple obese controls [male (4.5± 1.7) μg/L, female (10.5±2.4) μg/L] ( P <0.01, P <0.05). (2) Serum leptin levels were significantly correlated with BMI in both OSAS patients ( r =0.64, P <0.01) and simple obese controls ( r =0.59, P <0.01), but only in OSAS patients was the leptin level significantly correlated with apnea and hypopnea index (AHI) ( r =0.47, P <0.01) and with neck circumference ( r =0.64, P <0.01). Conclusions Serum leptin levels were higher in OSAS patients than in simple obese controls. Besides obesity and neck circumference,OSAS may also influence the leptin system, resulting in increased serum leptin level.