代谢综合征与阻塞性睡眠呼吸暂停低通气综合征独立相关  

An independent association detected between metabolic syndrome and obstructive sleep apnea-hypolmea syndrome

作　　者：臧淑妃[1] 潘志杰[2] 李成江[1] 

机构地区：[1]浙江大学医学院附属第一医院内分泌科,杭州310003 [2]浙江大学医学院附属第一医院呼吸科,杭州310003

出　　处：《中华内分泌代谢杂志》2008年第4期400-403,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的探讨代谢综合征（MS）与阻塞性睡眠呼吸暂停低通气综合征（OSAHS）可能存在的关系。方法将82例经多导睡眠图（PSG）监测的肥胖者分为肥胖OSAHS组（55例）和肥胖非OSAHS组（27例），并选取30名正常体重者为正常对照组。测肥胖者的多导睡眠参数呼吸暂停低通气指数（AHI）、手指脉搏血氧饱和度（Spo2）；所有受试者均测身高、体重、血压、腰围以及外周循环中代谢参数空腹血糖（FBG）、空腹胰岛素（FINS）、血清尿酸和血脂；以稳态模式评估胰岛素抵抗（HOMA-IR）。比较肥胖OSHAS组和肥胖非OSAHS组间MS的患病率、各组间代谢指标的差异性，并分析肥胖OSHAS组各指标之间的相关性。结果肥胖OSAHS组MS患病率明显高于肥胖非OSAHS组（69．09％ vs 37．04％，P〈0．01）。肥胖OSAHS组的收缩压、舒张压、FBG、HOMA-IR均高于肥胖非OSAHS组（P〈0．05或P〈0．01），而高密度脂蛋白胆固醇（HDL-C）则低于肥胖非OSAHS组（P〈0．01）。多元逐步回归分析表明舒张压与最低手指脉搏血氧饱和度（LSPpo2）呈负相关，FINS、HOMA-IR与AHI呈正相关。结论OSAHS与MS具有独立相关性，并可能是心脑血管疾病和其它全身性疾病的危险因素。Objective To investigate possible independent association between metabolic syndrome （MS） and obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods According to polysomnography （PSG） examination, 82 obese patients were divided into OSAHS group （ n = 55 ） and non OSAHS group （ n = 27 ） and 30 subjects with normal weight were recruited as the control group. PSG parameters such as AHI （ apnea hyponea index）, oxygen saturation （Spo2） in obese patients were measured. MS-associated parameters, such as fasting blood glucose （ FBG ）, fasting insulin （ FINS ）, plasma lipid profile, insulin homeostasis model assessment of insulin resistance （HOMA-IR） and blood pressure, height, body weight, waist circumference, were measured in all cases. The prevalence of MS and the parameters were compared among different groups. The correlations between them were analyzed. Results The prevalence of MS in obese patients with OSAHS was significantly higher than that in obese patients without OSAHS （69.09% vs 37.04%, P 〈0.01 ）. Systolic blood pressure and diastolic blood pressure （ DBP）, FBG and HOMA-IR were higher in subjects with OSAHS than those without OSAHS （P 〈 0.05 or P 〈 0.01 ）. Multiple stepwise regression showed that DBP was negatively correlated with Spo2, FINS and HOMA-IR were positively correlated with AHI. Conclusion OSAHS is found to be independently associated with MS, which may be a risk factor of cardiovascular disease and other systemic diseases.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 代谢综合征 胰岛素抵抗 

分 类 号：R766[医药卫生—耳鼻咽喉科]