2型糖尿病并OSAHS病人颈围与颈长测定及意义

ASSOCIATION OF NECK CIRCUMFERENCE AND NECK LENGTH WITH OBSTRUCTIVE SLEEP APNEA HYPOPNEA SYNDROME IN PATIENTS WITH TYPE 2 DIABETES

目的了解2型糖尿病(DM)并打鼾病人颈围、颈长、体脂成分与呼吸暂停低通气指数(AHI)的相关性。方法选取2型DM并夜间睡眠打鼾者130例,测量其颈围、颈长、身高、体质量、内脏脂肪指数、身体脂肪率、皮下脂肪率,并应用多导睡眠监测仪测量AHI、氧减指数、最低血氧饱和度,根据AHI分为单纯DM组(<5h-1)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)组(≥5h-1);根据AHI分为正常、轻度、中度、重度4组(AHI分别为<5、5~14、15~29、≥30h-1),分析组间BMI、腰围、臀围、颈围、颈长、体脂成分与AHI的相关性,同时对各指标进行Logistic回归分析。结果 OSAHS组病人颈围大于单纯DM组,差异有显著意义(t=2.185,P<0.05)。男性病人OSAHS的严重程度与BMI、内脏脂肪指数、身体脂肪率以及皮下脂肪率有关(F=4.371~6.946,P<0.05)。Logistic回归分析显示,颈围、颈长是OSAHS患病独立危险因素(OR=1.263、1.613,P<0.05)。结论 2型DM并OSAHS病人颈围、颈长与OSAHS有关系,为临床及科研工作中OSAHS的研究奠定基础。

Objective To investigate the correlations of neck circumference,neck length,and body fat composition with apnea hypopnea index（AHI）in type 2diabetes mellitus（DM）patients with snoring. Methods A total of 130 type 2DM patients with snoring were enrolled in the study.The following indicators were measured：neck circumference,neck length,body height,body mass index（BMI）,visceral fat index,body fat rate,and subcutaneous fat rate.AHI,oxygen desaturation index（ODI）,and the lowest oxygen saturation were measured using polysomnography（PSG）.According to the AHI,the patients were divided into DM group（AHI〈5h-1）and DM＋obstructive sleep apnea hypopnea syndrome（OSAHS）group（AHI≥5h-1）,and the patients were divided into normal,mildlight,moderatemedium,and severe groups in terms of the severity of their OSAHS（AHI〈5,5-14,15-29,≥30h-1,respectively）.The correlations of BMI,waist circumference,hip circumference,neck circumference,neck length,and body fat composition with AHI were analyzed,and logistic regression analysis was performed to determine the risk factors for OSAHS. Results The DM＋OSAHS group showed a significantly larger neck circumference than the DM group（t=2.185,P〈0.05）.The severity of OSAHS was correlated with BMI,visceral fat index,body fat rate,and subcutaneous fat rate in men（F=4.371-6.946,P〈0.05）.The logistic regression analysis showed that neck circumference and neck length were independent risk factors for OSAHS in patients with type 2DM（OR=1.263,1.613;P〈0.05）. Conclusion Neck circumference and neck length are independent factors contributing to OSAHS in type 2DM patients with snoring,which can provide a reference for the clinical and scientific research on OSAHS.