瘦素、胰岛素生长因子-1与OSAHS关联性的研究

Correlation of OSAHS with leptin and insulin-like growth factor-1

目的：探讨肥胖相关的血清因子瘦素（LEP）、胰岛素生长因子-1（IGF-1）与阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）的关联性,为指导OSAHS临床诊治和预防提供科学依据。方法将华北理工大学附属医院呼吸科睡眠室和唐山协和医院耳鼻喉科睡眠室就诊并经过PSG（多导睡眠监测）确诊的131例重度OSAHS患者作为病例组；健康查体的90例非OSAHS者作为正常非肥胖组,其中45例BMI〉=25的为正常肥胖组,另45例BMI〈25的为正常非肥胖组。所有入选对象均使用统一调查表收集患者的一般情况、临床特征等资料填表登记；并对每位入选对象,清晨空腹采血检测瘦素、胰岛素生长因子-1（ IGF-1）。结果在本研究中,LEP水平在正常对照组最低,肥胖对照组次之,病例组最高,3组间差异无统计学意,LEP暴露水平与OSAHS的关联有统计学意义。 LEP水平升高,OSAHS危险性增高（χ^2=6．45,OR 2．47）。而上述3个组间的IGF-1水平比较（P=0．00）。两两比较,各项指标均以病例组最低,肥胖组次之,正常对照组最高,组间差异均有统计学意义。（OR=6．94）。结论 LEP、IGF-1水平与OSAHS均有关联,LEP水平升高,OSAHS危险性增高,IGF-1暴露水平低的肥胖者,OSAHS的危险性升高。

Objective To investigate the relationship of obstructive sleep apnea hypopnea syndrome （ OSAHS） with leptin and insulin-like growth factor-1 （IGF-1）. Methods The study selected 131 patients with severe OSAHS as the group A, 45 healthy controls without OSAHS as the group B and 45 obesity controls as the group C. All of them were diagnosed by PSG. The serum leptin and IGF-1 from everyone were measured. Results The level of leptin in the OSAHS group was the highest, it showed no significant difference among the 3 groups （P〉0. 05）. The level of LEP was correlated with OSAHS （P〈0. 05）. The high level of LEP increased the risk of OSAHS（χ^2 =6. 45, OR=2. 47）. The level of IGF-1 was the lowest in the OSAHS group, followed by the control group and the obesity control group （P〈0. 05）. Conclusion The levels of leptin and IGF-1 are correlated with OSAHS, and the higher leptin and lower IGF-1 indicate OSAHS patients with high risk.