瘦素超敏C反应蛋白在糖耐量减低并睡眠障碍患者中的临床意义

Clinical Significance of Detecting Leptin Hypersensitive C-reactive Protein in Patients with Impaired Glucose Tolerance and Sleep Disorders

目的:探讨瘦素(Leptin)、超敏C反应蛋白(hs CRP)在糖耐量减低(IGT)并睡眠障碍中临床意义。方法:选择2015年5月至2017年5月就诊的无糖尿病史患者;行口服葡萄糖耐量试验(OGTT)评估血糖代谢情况,采用匹兹堡睡眠质量指数(PSQI)评定睡眠状况;筛选出72例IGT患者,根据PSQI评分情况,IGT患者分为IGT+睡眠障碍组,IGT+非睡眠障碍组;另外选取同期糖耐量正常且无睡眠障碍者58例为对照组。测定各组hs CRP、瘦素、胰岛功能等指标。结果:IGT并非睡眠障碍组、IGT并睡眠障碍组FPG、2h PG、2h Ins中位数水平均高于对照组(P<0.05);IGT并非睡眠障碍组Hb A1c、HOMA-IR中位数水平高于对照组(P<0.05);IGT并非睡眠障碍组、IGT并睡眠障碍组Leptin中位数水平明显高于对照组(P<0.05)。IGT并睡眠障碍组hs CRP中位数水平高于IGT并非睡眠障碍组,IGT并非睡眠障碍组hs CRP中位数水平高于对照组(P均<0.05)。IGT并睡眠障碍组PSQI中位数水平高于IGT并非睡眠障碍组及对照组(P<0.05)。Logistic回归分析显示,睡眠障碍与2h PG、hs CRP呈正相关(P<0.05);高胰岛素血症、PSQI与糖耐量减低呈正相关(P<0.05)。结论:IGT并睡眠障碍患者hs CRP、Leptin水平明显增高,炎症反应、瘦素在睡眠障碍中发挥一定作用,可能进一步加重胰岛素抵抗,从而增加糖耐量减低的发病风险。

Objective:To explore the clinical value of detecting leptin,hypersensitive c-reactive protein in serum in patients with Impaired glucose tolerance and sleep disorders.Methods:Choose hospitalized patients with no history of diabetes from May 2015 to May 2017.The oral glucose tolerance test(OGTT)was tested to assess blood glucose metabolism and Pittsburgh sleep quality index(PSQI)was evaluated to assess sleep status.72 IGT patients were selected.According to the PSQI score,IGT patients were divided into IGT+sleep disorder group and IGT+non-sleep disorder group.In addition,58 patients with normal glucose tolerance and no sleep disorder were selected as the control group.HsCRP,leptin and pancreas islet function were measured in each group.Results:The median levels of FPG,2hPG and 2hIns in the IGT with non-sleep disorder group and the IGT with sleep disorder group were higher than those in the control group(P<0.05);the median level of HbA1c and HOMA-IR in IGT with non-sleep disorder group was higher than that in the control group(P<0.05).The median level of Leptin in the IGT with non-sleep disorder group and the IGT with sleep disorder group was higher than that in the control group(P<0.05);The median level of hsCRP in the IGT with sleep disorder group was higher than that in the IGT with non-sleep disorder group,the median hsCRP of the IGT with non-sleep disorder group was higher than that of the control group(all P<0.05).The median level of PSQI in the IGT with sleep disorder group was higher than in the IGT with non-sleep disorder group and the control group(P<0.05).Logistic regression analysis showed that sleep disorders was positively correlated with 2hPG and hsCRP(P<0.05);Hyperinsulinemia,PSQI and glucose tolerance were positively correlated(P<0.05).Conclusion:Levels of hsCRP and leptin were significantly increased in patients with IGT and sleep disorders,inflammation and leptin play a role in sleep disorders,which may further aggravate insulin resistance and thereby increase the risk of glucose tolerance reduction.