OSAHS合并高血压病人血清脂联素和内脏脂肪素变化的研究

Study on the changes of serum adiponectin and visfatin in patients with obstructive sleep apnea hypopnea syndrome combined with hypertension

目的探讨血清脂联素和内脏脂肪素在阻塞性睡眠呼吸暂停综合征(OSAHS)合并高血压病人体内的变化。方法结合病人睡眠呼吸暂停指数(apnea hyponea index,AHI)和高血压发病情况,将所有病人分为单纯性鼾症组(20例)、OSAHS组(20例)、OSAHS合并高血压组(20例);测定其血清脂联素和内脏脂肪素水平,同时测定身高、体质量和体质量指数等指标,并分析各组间以上指标以及脂联素、内脏脂肪素的差异。结果 OSAHS组和OSAHS合并高血压组与单纯性鼾症组比较,血清脂联素水平均较低,内脏脂肪素水平均较高(P<0. 01)。OSAHS合并高血压组血清脂联素水平低于OSAHS组,内脏脂肪素水平高于OSAHS组(P<0. 01)。相关分析显示,OSAHS合并高血压组的血清脂联素与AHI之间存在显著负相关(P<0. 01),内脏脂肪素与AHI呈显著正相关(P<0. 01)。多元回归分析显示AHI是脂联素、内脏脂肪素水平的独立相关因素(P<0. 01)。结论脂联素和内脏脂肪素的表达可能与OSAHS合并高血压的发生发展有密切的关系。

Objective To investigate the levels of serum visfatin and adiponectin in the patients with obstructive sleep apneahypopnea syndrome（ OSAHS） with hypertension. Methods According to the incidence of hypertension and the level of apnea hyponea index（ AHI）,all patients were divided into three groups： the simple snoring group（ AHI5,n = 20）,the OSAHS group（ AHI≥5,n = 20）,OSAHS combined with hypertension group（ AHI≥5,n = 20）. The serum levels of adiponectin and serum visfatin were measured by ELISA. Additionally,the levels of height,body weight,and the body mass index were recorded. The above indexes were compared between the groups. Results Compared with the simple snoring group, the levels of serum adiponectin in the OSAHS group and OSAHS combined with hypertension group were lower,and the levels of serum visfatin were higher（ P〈0. 01）.The serum level of adiponectin in OSAHS combined with hypertension group was lower,and the level of visfatin was higher than that in the OSAHS group（ P〈0. 01）. Correlation analysis showed that there was a negative correlation between AHI and serum adiponectin,and there was a positive correlation between AHI and serum visfatin in OSAHS combined with hypertension group（ P〈0. 01）. Multiple regression analysis showed that AHI was the independent correlation factor of the level of serum adiponectin and visfatin.Conclusions Serum adiponectin and visfatin may be closely related to the development of hypertension in the patients with OSAHS.