2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征患者血清Chemerin、Nesfatin-1、Obestatin的检测水平及意义

Detection levels and significance of serum Chemerin,Nesfatin-1 and Obestatin in patients with type 2 diabetes mellitus complicated obstructive sleep apnea hypopnea syndrome

目的探讨2型糖尿病(T2DM)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清人趋化素(Chemerin)、摄食抑制因子(Nesfatin-1)、肥胖抑制素(Obestatin)水平及意义。方法回顾性收集2018年8月至2019年6月就诊于首都医科大学大兴教学医院的T2DM患者75例,T2DM合并OSAHS患者43例,同期体检健康者78名作为研究对象。通过酶联免疫吸附试验法检测各组血清Chemerin、Nesfatin-1、Obestatin水平,通过二元Logistic回归分析影响T2DM合并OSAHS发生的影响因素。结果与对照组相比,T2DM组、T2DM合并OSAHS组体重指数(BMI)、糖化血红蛋白(Hb A1c)、Chemerin、Nesfatin-1水平显著升高,Obestatin水平显著降低,差异均有统计学意义(P<0.05);与T2DM组相比,T2DM合并OSAHS组BMI、Hb A1c、Chemerin、Nesfatin-1水平显著升高,Obestatin水平显著降低,差异均有统计学意义(P<0.05)。Pearson分析显示,T2DM合并OSAHS患者血清Chemerin、Nesfatin-1均与BMI、呼吸暂停低通气指数(AHI)、Hb A1c正相关(P<0.05),与LSa O_(2)、MSaO_(2)负相关(P<0.05);Obestatin水平与BMI、AHI、Hb A1c负相关(P<0.05),与LSa O_(2)正相关(P<0.05)。二元Logistic回归分析显示,BMI、Chemerin、Nesfatin-1水平是影响OSAHS合并T2DM发病的独立危险因素(P<0.05),Obestatin水平是影响OSAHS合并T2DM发病的保护因素(P<0.05)。结论T2DM合并OSAHS患者血清Chemerin、Nesfatin-1高表达,血清Obestatin低表达,三者与T2DM合并OSAHS发病密切相关。

Objective To investigate the levels and significance of serum human chemokine,Nesfatin-1 and obestatin in patients with type 2 diabetes mellitus(T2DM)complicated obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From August 2018 to June 2019,75 patients with T2DM,43 patients with T2DM complicated OSAHS,and 78 healthy people who treated in Daxing Teaching Hospital of Capital Medical University from August 2018 to June 2019 were collected retrospectively as the subjects.The levels of serum Chemerin,Nesfatin-1 and Obestatin were detected by enzyme-linked immunosorbent assay,and the influencing factors of T2DM complicated OSAHS were analyzed by binary logistic regression.Results Compared with the control group,body mass index(BMI),hemoglobin A1c(HbA1c),Chemerin and Nesfatin-1 levels of T2DM group and T2DM complicated OSAHS group were significantly higher,while the level of Obestatin was significantly lower,the differences were statistically significant(P<0.05);compared with T2DM group,BMI,HbA1c,Chemerin and Nesfatin-1 levels of T2DM complicated OSAHS group were significantly higher,while the level of Obestatin was significantly lower,the differences were statistically significant(P<0.05).Pearson analysis showed that serum Chemerin and Nesfatin-1 were positively correlated with BMI,apneahypopneaindex(AHI)and HbA1c,and negatively correlated with LSaO_(2) and MSaO_(2)(P<0.05);Obestatin was negatively correlated with BMI,AHI and HbA1c(P<0.05),and positively correlated with LSaO_(2)(P<0.05).Binary Logistic regression analysis showed that BMI,Chemerin and Nesfatin-1 were independent risk factors for OSAHS with T2DM(P<0.05),and Obestatin level was the protective factor of OSAHS with T2DM(P<0.05).Conclusion The expressions of Chemerin and Nesfatin-1 in serum are high in patients with T2DM complicated OSAHS,the expression of Obestatin in serum is low,and these three factors are closely related to T2DM with OSAHS.