2型糖尿病患者阻塞性睡眠呼吸暂停综合征相关因素分析

Related factors of obstructive sleep apnea sysdrome in type 2 diabetes patients

目的:探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)的患病率,并分析其相关危险因素。方法 :选择患者289例,使用便携式睡眠呼吸监测仪监测睡眠呼吸情况。分析OSAS患病状况,并探讨其相关因素。最终完成睡眠呼吸监测者254例。根据诊断分为OSAS组183例和非OSAS组71例。结果:最终纳入254例T2DM患者,符合OSAS诊断标准的患者183例(占72%),其中男108例(占59%)。与非OSAS组比较,OSAS组患者糖尿病病程、体质指数、餐后2 h血糖、空腹胰岛素、胰岛素抵抗指数、收缩压、甘油三酯、低密度脂蛋白胆固醇以及同型半胱氨酸水平显著升高(P<0.01),OSAS组患者血脂异常、高尿酸血症、高血压、非酒精性脂肪肝以及代谢综合征的患病率显著高于对照组(P<0.01)。Logistic回归分析显示冠心病、体质指数、血脂异常以及高同型半胱氨酸水平是OSAS的独立危险因素。结论:T2DM患者OSAS患病率较高,OSAS患者血糖、体质指数及各种代谢指标升高,肥胖及胰岛素抵抗是两者相互影响的主要原因。

Objective To analyze the related factors of obstructive sleep apnea syndrome （OSAS） in type 2 diabetes mellitus （T2DM） patients. Methods 289 participants were enrolled and 254 people finished the whole process. Portable sleep monitor was used to detect the breath situation during sleep, and related factors were also analyzed. Finally, 183 subjects were diagnosed as OSAS and 71 subjects were not. Results 254 T2DM subjects were enrolled, with 108 males （59%） and 183 participants were diagnosed as OSAS （72%）. OSAS group had a higher diabetic duration,body mass index, 2 h plasma glucose,fasting insulin, C peptide level, systolic blood pressure, triglyeeride, low density lipoprotein cholesterol, and homocysteine levels（P〈0.01）. The prevalences of dyslipidemia, hyperuricemia, high blood pressure, non-alcoholic fatty liver disease and metabolic syndromein OSAS group were also higher than that in compared groups. Logistic regression analysis showed that body mass index, dyslipidemia and high homocysteine level were independent risk factors of OSAS. Conclusions The prevalence of OSAS in T2DM was higher. Blood glucose level, body mass index and multiple metabolic parameters in OSAS patients elevated significantly. Obesity and insulin resistance were major factors during the process of the disease.