肥胖对阻塞性睡眠呼吸暂停低通气综合征患者甲状腺功能的影响

Effect of obesity on thyroid function in patients with OSAHS

目的探讨肥胖与阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者甲状腺功能变化关系及对其影响作用。方法筛查出OSAHS伴肥胖患者50例,OSAHS不伴肥胖患者50例,单纯肥胖患者50例,各组患者均有男46例、女4例,测定各组患者体质量指数(BMI)、呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度、血清TSH、FT3、FT4、血清瘦素水平,各组间相互比较及有差异指标相关性分析。结果 OSAHS伴肥胖组、OSAHS不伴肥胖组、单纯肥胖组各组患者年龄差异无统计学意义(P> 0.05);各组BMI、AHI、最低血氧饱和度、TSH、FT3、FT4、瘦素水平差异有统计学意义(P <0.01);OSAHS伴肥胖组与OSAHS不伴肥胖组患者AHI、最低血氧饱和度差异无统计学意义(P> 0.05);OSAHS伴肥胖组患者瘦素水平、FT3较OSAHS不伴肥胖组及单纯肥胖组患者均较高,差异有统计学意义(P <0.01);OSAHS伴肥胖组患者TSH、FT4较OSAHS不伴肥胖组及单纯肥胖组患者均较低,差异有统计学意义(P <0.01);OSAHS伴肥胖组患者TSH、FT4与血清瘦素水平呈负相关(P <0.01),FT3与血清瘦素水平呈正相关(P <0.01)。结论肥胖对OSAHS患者甲状腺功能有影响作用,影响机制可能与瘦素水平有关。

Objective To investigate the relationship between obesity and the change of thyroid function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and its effect of obesity on the function of thyroid.Methods Fifty OSAHS patients with obesity,50 OSAHS patients without obesity,and 50 patients with simple obesity were screened out,which all included 46 males and 4 females.The body mass index(BMI),low ventilation index(AHI),minimum blood oxygen saturation at night,TSH,FT3,FT4,and leptin in serum were measured to compare with each other and analyze the correlation between different indicators.Results There was no statistical difference in age among the three groups(P>0.05).BMI,AHI,minimum blood oxygen saturation,TSH,FT3,FT4,and leptin levels were significantly different between the groups(P<0.01);there was no differ⁃ence in AHI and minimum blood oxygen saturation between OSAHS obesity group and OSAHS non-obesity group(P>0.05).The levels of leptin and FT3 in OSAHS obesity group were higher than those in OSAHS obesity group and simple obesity group,with statistically significant differences(P<0.01);TSH and FT4 in OSAHS obesity group were lower than those in OSAHS non-obesity group and simple obesity group,with statistically significant differences(P<0.01);TSH and FT4 were negatively correlated with serum leptin levels in patients with OSAHS and obesity(P<0.01),and FT3 was positively correlated with serum leptin levels(P<0.01).Conclusion Obe⁃sity has an effect on thyroid function in patients with OSAHS,and the mechanism may be related to leptin levels.