阻塞性睡眠呼吸暂停低通气综合征患者血浆抵抗素和脂联素水平与胰岛素抵抗的相关研究  

Relationship between resistin, adiponectin and insulin resistance in patients with obstructive sleep apnea-hypopnea syndrome

作　　者：王强[1] 樊利萍[1] 王蓓[1] 刘卓拉[1] 陈晓阳[1] 

机构地区：[1]山西医科大学第二医院呼吸科,太原030001

出　　处：《中国综合临床》2009年第10期1018-1020,共3页Clinical Medicine of China

基　　金：山西省卫生厅科技攻关计划项目（200517）

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血浆抵抗素和脂联素水平与胰岛素抵抗程度的相关性。方法根据整夜多导睡眠监测（PSG）和既往病史将68例OSAHS患者分为轻度（24例）、中度（13例）、重度（31例）OSAHS组，并设正常对照组（20例）。检测各组空腹血糖、胰岛素、血脂、抵抗素、脂联素水平，计算稳态模型胰岛素抵抗指数（HOMA—IR），并分析HOMA—IR与抵抗素、脂联素、血脂、体重指数、腰臀比、睡眠呼吸暂停低通气指数（AHI）、最低血氧饱和度（LSa02）、夜间血氧饱和度低于90％的时间占总睡眠时间的百分比（T90）等指标的相关性。结果轻、中、重度OSAHS组的抵抗素水平[分别为（8．04±2．14）、（10．85±4．89）、（13．34±3．52）mg／L]均明显高于正常对照组[（5．14±1．94）mg／L]差异均有统计学意义（P均〈0．05），且OSAHS重度组明显高于轻度组（P〈0．05）。脂联素在OSAHS轻度[（6．21±1．74）mg／L]、中度[（4．19±1．80）mg／L]、重度[（2．26±1．17）mg／L]组的水平均明显低于正常对照组[（9．49±2，40）mg／L]，且OSAHS各组间差异均有统计学意义（P均〈0．05）。OSAHS中、重度组的HO-MA．IR（4．07±0．97、5．61±2．26）明显高于OSAHS轻度组（1．57±0．58）和正常对照组（2．47±1．52），且OS—AHS中、重度组间差异也有统计学意义（P均〈0．05）。Spearman相关分析显示HOMA—IR与抵抗素、总胆固醇、甘油三酯、体重指数、腰臀比、AHI、190有显著正相关（r值分别为0．794、0．438、0．430、0．351、0．456、0．775、0．624，P均〈0．01），与脂联素、LSaO2有显著负相关（r值为-0．563、-0．623，P均〈0．01）。偏相关分析显示控制脂联素和抵抗素影响后，HOMA—IR与1、90、AHI有显著正相关（r值分别为0．231、0．358，P均〈0．05）。多元逐步回归分析显示AObjective To explore relationship between resistin＇adiponectin and insulin resistance （IR） in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods Based on polysomnography （PSG） and disease history ,68 patients were divided into three groups ： mild （ L, n = 24 ）, moderate （ M, n = 13 ）, severe （ S, n = 31 ） OSAHS, and normal control （ n = 20 ）. Fasting serum glucose, insulin, lipoids, resistin and adiponectin were measured. HOMA-IR was calculated, the correlation between HOMA-IR and resistin, adiponectin, lipoids, body mass index ,waist-to-hip ratio, apnea-hypopnea index （AHI）, the lowest saturation of blood oxygen （LSaO2） and the percentage of total sleep time spent with an oxygen saturation less than 90% （T90） were analysed. Results The levels of serum resistins in each OSAHS group were （ 8.04 ± 2.14）, （ 10.85 ± 4.89）, （ 13.34 ± 3.52） mg/L, and were significantly higher than those in control group （9.49 ± 2.40） mg/L （ P 〈 0.05 ）, S were significantly higher than L （P〈0.05） ;The levels of serum adiponectin of OSAHS groups were（6.21 ± 1.74）, （4. 19 ± 1.80）, （2.26 ± 1.17 ）mg/L, and were significantly lower than those in control group （9.49 ± 2.40） mg/L （ P 〈 0.05 ）, and the intergroup differences were statistically significant （P 〈 0.05 ）. HOMA-IR of M and S were （4.07 ± 0.97 ）, （ 5.61 ± 2.26 ） significantly higher than those of L and control group （ 1.57 ± 0.58 ）, （2.47 ± 1.52 ） （ P 〈 0.05 ）, and intergroup differences between M and S were statistical significant（P 〈0.05）. Spearman correlation analysis showed that HOMA-IR was significantly positive correlated with resistin, total cholesterol, triglyceride, body mass index, waist-hip ratio, AHI, T90 （ r = 0. 794,0.438,0. 430,0.351,0. 456,0. 775,0. 624, P 〈 0.01 ） , negative with adiponectin, LSaO2 （r = -0. 563, -0. 623 ,P 〈0.01 ）. Partial correlation analysis showed that after the effect of adip

关 键 词：睡眠呼吸暂停低通气综合征 胰岛素抵抗 抵抗素 脂联素 

分 类 号：R587.1[医药卫生—内分泌]