2型糖尿病患者阻塞性睡眠呼吸暂停低通气综合征分布情况及危险因素分析

Analysis on Distribution and Risk Factors of Obstructive Sleep Apnea Hypopnea Syndrome in Type 2 Diabetic Patients

目的:探讨2型糖尿病患者中阻塞性睡眠呼吸暂停低通气综合征(OSAHS)分布情况及其危险因素。方法:收集2020年1月-2022年3月石嘴山市第一人民医院内分泌科就诊的150例2型糖尿病患者为研究对象,根据是否有OSAHS进行分组,未合并OSAHS者为单纯糖尿病组28例,根据OSAHS的病情严重程度分为轻度组78例,中度组29例,重度组15例,探讨2型糖尿病发生OSAHS的危险因素。结果:150例患者中合并OSAHS 122例,患病率为81.3%,其中轻度OSAHS组78例,占52.0%,中度OSAHS组29例,占39.3%,重度OSAHS组15例,占10.0%;单纯2型糖尿病和轻、中、重度OSAHS四组间在病程、腰围、体重指数(BMI)、胰岛素抵抗指数、糖化血红蛋白、低密度脂蛋白、尿酸方面比较,差异有统计学意义(P<0.05);单纯2型糖尿病和轻、中、重度OSAHS四组在性别、年龄、空腹血糖、甘油三酯、胆固醇、血红蛋白方面比较,差异无统计学意义(P>0.05);腰围增大、尿酸升高、低密度脂蛋白升高、糖化血红蛋白升高是2型糖尿病合并OSAHS的危险因素。结论:2型糖尿病患者中OSAHS的患病率较高,病程、腰围、BMI、胰岛素抵抗指数、糖化血红蛋白、低密度脂蛋白、尿酸是监测是否合并OSAHS的重要指标;高低密度脂蛋白、高血尿酸、高水平糖化血红蛋白等是OSAHS的危险因素。

Objective:To investigate the distribution and risk factors of obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with type 2 diabetes mellitus.Methods:A total of 150 patients with type 2 diabetes mellitus who were admitted to Endocrinology Department of Shizuishan First People’s Hospital from January 2020 to March 2022 were selected as the study subjects,and they were divided into groups according to the presence/absence of OSAHS.Patients without OSAHS were included as simple diabetes group (28 cases);and patients with OSAHS were divided into mild group (78 cases),moderate group (29 cases)and severe group (15 cases) according to the severity of OSAHS.The risk factors of OSAHS in type 2 diabetes mellitus were studied.Results:Among 150 patients,122 cases were complicated with OSAHS and the prevalence rate was 81.3%.There were78 cases (52.0%) in mild OSAHS group,29 cases (39.3%) in moderate OSAHS group,and 15 cases (10.0%) in severe OSAHS group.There were significant differences in the course of disease,waist circumference,body mass index (BMI),insulin resistance index,glycosylated hemoglobin,low density lipoprotein and uric acid among four groups,namely simple diabetes group,mild OSAHS group,moderate OSAHS group and severe OSAHS group (P<0.05).There was no significant difference in gender,age,fasting plasma glucose (FPG),triglyceride (TG),cholesterol (TC) and hemoglobin (Hb) among four groups,namely simple diabetes group,mild OSAHS group,moderate OSAHS group and severe OSAHS group (P>0.05).Increased waist circumference,increased uric acid,increased low density lipoprotein and increased glycosylated hemoglobin were risk factors of type 2 diabetes mellitus complicated with OSAHS.Conclusion:Patients with type 2 diabetes mellitus have a high prevalence of OSAHS.Course of disease,waist circumference,BMI,insulin resistance index,glycosylated hemoglobin,low density lipoprotein and uric acid are important indicators to monitor the presence of OSAHS complication.High low-density lipoprotein,high blood uric acid and high level of glycosylated hemoglobin are risk factors of OSAHS.