摘要
目的·评估阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnoea hypoxia syndrome, OSAHS)合并非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者血清脂肪代谢相关激素水平及其潜在作用。方法·选取因鼾症就诊患者,根据多导睡眠图监测及NAFLD筛查分为OSAHS+NAFLD组、OSAHS组、NAFLD组和对照组,比较血清脂肪代谢相关激素等指标;将OSAHS患者分别依据呼吸暂停低通气指数(apnea hypopnea index,AHI)和夜间最低动脉血氧饱和度(minimum arterial oxygen saturation,MinSaO_2)分为轻度、中度、重度3组,比较NAFLD发生情况;采用多元回归分析明确NAFLD发病的独立预测因素。结果·OSAHS组、NAFLD组及OSAHS+NAFLD组的AHI、MinSaO_2、动脉血氧饱和度<90%的时间百分比(TSaO_2<90%)、体质量指数、脂联素、瘦素、高敏C反应蛋白及脂多糖与对照组比较,差异均有统计学意义(均P<0.05);不同程度OSAHS患者的NAFLD发生率(17.0%、51.6%和97.2%)比较,差异有统计学意义(P=0.006);不同程度MinSaO_2的OSAHS患者NAFLD发生率(18.2%、57.1%和91.9%)比较,差异也有统计学意义(P=0.011)。多元回归分析显示体质量指数、AHI、脂联素为NAFLD发病的独立预测因素(P=0.006,P=0.020,P=0.008)。结论·随着OSAHS严重程度增大,NAFLD发病率逐渐升高;OSAHS合并NAFLD患者血清脂联素、瘦素水平与NAFLD病情严重程度有关。
Objective·To assess the level of serum lipid metabolism related hormones in the patients of obstructive sleep apnoea hypoxia syndrome(OSAHS)combine with non-alcoholic fatty liver disease(NAFLD),and explore the potential role in the pathogenesis.Methods·Patients that main complaint for snoring were selected.According to polysomnography and NAFLD screening,the patients were divided as follows:OSAHS+NAFLD group,OSAHS group,NAFLD group,and control group,and the levels of serum lipid metabolism related hormones were measured.The patients with OSAHS were divided into three groups,i.e.,mild,moderate and severe groups according to the degree of apnea hypopnea index(AHI)and minimal oxyhemoglobin saturation(MinSaO2)respectively.The statistical analysis about the morbidity of NAFLD in the patients with different OSAHS severity were analyzed.Multiple regression analysis was used to determine the independent predictors of NAFLD.Results·Significant differences were found in AHI,MinSaO2,the duration of hemoglobin desaturation(TSaO2<90%),body mass index,adiponectin,leptin,high sensitive C reactive protein and lipopolysaccharide(P<0.05 for all)among the groups of OSAHS,NAFLD and OSAHS+NAFLD.The morbidity of NAFLD exited statistical difference in the patients with different OSAHS severity(17.0%,51.6%and 97.2%,P=0.006),and the same trend was seen in the patients with different MinSaO2 severity(18.2%,57.1%and 91.9%,P=0.011).Multiple regression analysis showed that body mass index,AHI and adiponectin were independent predictors of the morbidity of NAFLD(P=0.006,P=0.020 and P=0.008).Conclusion·The morbidity of NAFLD increases with the worsening of OSAHS.There is positive correlation between the severity and the level of serum adiponectin and leptin in the patients with OSAHS and NAFLD.
作者
应晨
刘彩虹
胡家安
江石湖
徐志红
孙璟
YING Chen;LIU Cai-hong;HU Jia-an;JIANG Shi-hu;XU Zhi-hong;SUN Jing(Department of Cardiology,Ruijin Hospital North,Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China;Department of Gerontology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Gastroenterology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《上海交通大学学报(医学版)》
CAS
CSCD
北大核心
2018年第10期1203-1207,共5页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海市卫生和计划生育委员会重要薄弱学科建设项目(2015ZB0503)~~
关键词
阻塞性睡眠呼吸暂停低通气综合征
非酒精性脂肪性肝病
脂联素
瘦素
obstructive sleep apnoea hypoxia syndrome(OSAHS)
non-alcoholic fatty liver disease(NAFLD)
adiponectin
leptin