阻塞性睡眠呼吸暂停综合征对患者糖脂代谢的影响

Effects of obstructive sleep apnea syndrome on glucose and lipid metabolism

目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)对患者糖脂代谢的影响。方法:回顾性分析2019年8月至2021年3月该院收治的100例OSAS患者的临床资料,依据呼吸暂停低通气指数(AHI)将患者分为3个亚组,AHI 5~14次/h为轻度组(n=53),AHI 15~29次/h为中度组(n=35),AHI≥30次/h为重度组(n=12),另外选取同期该院55名健康体检者为对照组。比较各组血脂指标[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]水平、糖代谢指标[空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]水平,并采用Pearson相关性分析法探讨睡眠质量指标[AHI、夜间最低血氧饱和度(LSaO_(2))、氧减指数(ODI)]与糖脂代谢指标的相关性。结果:各组TG、TC、LDL-C、FPG、FINS、HOMA-IR水平比较,重度组>中度组>轻度组≈对照组,差异有统计学意义(P<0.05)。AHI与TC、LDL-C、FINS、HOMA-IR均呈正相关,LSaO_(2)与TG呈负相关,ODI与TC、LDL-C呈正相关(P<0.05)。结论:中重度OSAS患者出现血糖、血脂水平异常,且异常程度与病情程度显著相关,AHI与TC、LDL-C、FINS、HOMA-IR均呈正相关,LSaO_(2)与TG呈负相关,ODI与TC、LDL-C呈正相关。临床可综合考虑OSAS患者的AHI、LSaO_(2)、ODI水平,及时给予降糖、降脂治疗,改善疾病预后。

Objective:To investigate effects of obstructive sleep apnea syndrome(OSAS)on glucose and lipid metabolism.Methods:The clinical data of 100 patients with OSAS admitted to this hospital from August 2019 to March 2021 were retrospectively analyzed.According to apnea hypopnea index(AHI),these patients were divided into three subgroups:mild group(AHI 5-14 times/h,n=53),moderate group(AHI 15-29 times/h,n=35)and severe group(AHI≥30 times/h,n=12).55 healthy subjects were selected as control group.The levels of blood lipid indexes[triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)]and the glucose metabolism indexes[fasting blood glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR)]were compared among the groups.Pearson correlation analysis was used to explore the correlations among the sleep quality indexes[AHI,lowest nocturnal oxygen saturation(LSaO_(2)),oxygen reduction index(ODI)]and the glucose and lipid metabolism indexes.Results:There were statistical differences in the levels of TG,TC,LDL-C,FPG,FINS and HOMA-IR among these group,severe group>moderate group>mild group≈control group(P<0.05).AHI was positively correlated with TC,LDL-C,FINS and HOMA-IR,LSaO_(2) was negatively correlated with TG,and ODI was positively correlated with TC and LDL-C(P<0.05).Conclusions:The patients with moderate to severe OSAS have abnormal blood glucose and blood lipid levels,and the degree of abnormality is significantly related to the degree of disease.AHI is positively correlated with TC,LDL-C,FINS and HOMA-IR,LSaO_(2) is negatively correlated with TG,and ODI is positively correlated with TC and LDL-C.Clinically,AHI,LSaO_(2) and ODI levels can be comprehensively considered,and the OSAS patients should be treated with hypoglycemic and lipid-lowering therapy to improve the prognosis of the disease.