呼出气冷凝液瘦素水平与阻塞性睡眠呼吸暂停低通气综合征肥胖的关系

Relationship between leptin in exhaled breath condensate and obesity in obstructive sleep apnea hypopnea syndrome

目的探讨呼出气冷凝液(EBC)中瘦素(LP)水平与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)肥胖程度的关系。方法随机抽取OSAHS患者120例,按多功能睡眠监测系统以及身体质量指数(BMI)的监测结果分为OSAHS肥胖组27例、OSAHS超重组59例、OSAHS体质量正常组34例,另选非OSAHS的30例打鼾患者作为非OSAHS对照组。采用酶联免疫分析法检测EBC中LP水平,分析OSAHS患者LP与BMI、睡眠呼吸暂停低通气指数(AHI)的相关性。结果OSAHS患者中,体质量正常组、超重组、肥胖组LP、BMI、AHI依次增高(P<0.01),OSAHS体质量超重组和肥胖组的LP、BMI、AHI均明显高于非OSAHS对照组(P<0.01);接受手术治疗的28例OSAHS患者手术后3个月平均体质量以及EBC中LP水平较手术前明显降低(P<0.05);LP水平与BMI、AHI呈显著正相关(P<0.01)。结论 OSAHS肥胖患者EBC中LP水平显著升高,与肥胖程度及OSAHS严重程度有相关性。

Objective To investigate the relationship between leptin（LP） level in exhaled breath condensate（EBC） and obesity in obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods 120 OSAHS patients were randomly selected and divided into OSAHS Obesity Group（27 cases）, OSAHS Overweight Group（59 cases） and OSAHS Normal Weight Group（34 cases） according to the monitoring results of the multi-functional sleep monitoring system and body mass index（BMI）. Additionally, 30 snoring patients with no OSAHS were selected as Non-OSAHS Control. The level of LP in EBC was detected by enzyme-linked immunosorbent assay, and the correlation of LP with BMI and sleep apnea hypopnea index（AHI） in OSAHS patients was analyzed. Results Among the patients with OSAHS, the LP, BMI and AHI in Normal-Weight, Overweight and obesity Group increased successively（P〈0.01）, and the LP, BMI and AHI in OSAHS Overweight and obesity Group were significantly higher than those of Non-OSAHS Control Group（P〈0.01）; The mean body weight and the LP level in EBC of 28 OSAHS patients undergoing surgery 3 months after surgery significantly decreased compared with those before the surgery（P〈0.05）; and the level of LP was positively correlated with BMI and AHI（P〈0.01）. Conclusion Significant increase of LP level in EBC of OSAHS obese patients is correlated with the obesity and the severity of OSAHS.