阻塞性睡眠呼吸暂停低通气综合征患者血糖波动的特征

Feature of the Daily Blood Glucose Fluctuation in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

目的观察阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者全天血糖波动的特征。方法根据多导睡眠图检测结果选取48例符合OSAHS诊断的受试对象作为OSAHS组,同时选取30例健康者作为对照组(N组)。动态监测两组受试者72 h血糖的变化,同时测定胰岛素抵抗指数(IRI)。结果 OSAHS组全天血糖平均值比对照组(5.98±1.21mmol/L vs 5.21±0.91mmol/L,P<0.05)升高;OSAHS组平均血糖波动幅度(MAGE)、夜间血糖波动幅度(NMAGE)及IRI较对照组(4.25±0.6 mmol/L vs 2.12±0.51mmol/L,1.93±0.04 vs 1.12±0.34和3.7±0.5 vs 2.4±0.2,P均<0.05)明显升高;OSAHS组:MAGE与呼吸暂停低通气指数(AHI)及IRI呈正相关(r=0.357、0.361,P均<0.05),AHI与IRI呈正相关(r=0.360,P<0.05)。结论 OSAHS患者全天血糖波动异常,存在严重的胰岛素抵抗。

Objective To investigate the feature about the blood glucose fluctuation in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods According to the result of polysomnography （PSG） test,78 subjects were divided into two groups：obstructive sleep apnea hypopnea syndrome group（ n = 48 ）, normal control group （n = 30）. The feature of the blood glucose profile were compared by continuous glucose monitoring systems （CGMS） and the insulin resistance index （IRI） were also compared. Results In patients with obstructive sleep apnea hypopnea syndrome,the 24 hours average glucose level was significantly higher than normal control group （5.98 ± 1.21mmol/L vs 5.21 -0.91mmol/L,P 〈0.05）. Compared with normal control group, the mean amplitude glyeemie excursions （MAGE） , the night mean amplitude glycemie excursions （NMAGE） and IRI were significantly higher （4.25 ± 0. 6mmol/L vs 2. 12±0.51mmol/L,1.93 ±0.04 vs 1.12±0.34,3.7±0.5 vs2.4~0.2,allP〈0.05）. In patients with OSAHS,the MAGE was positively correlated with the IRI and apnea hypoventilation index （AHI）. AHI and IRI also positively correlated. Conclusion The glucose metabolism abnormality and insulin resistance could be found in patients with obstructive sleep apnea hypopnea syndrome.