相同空腹血糖和合并不同程度OSAHS的糖尿病患者胰岛素抵抗的比较  

Comparison of IR between diabetes patient with different degree of OSAHS under the same fasting glucose level

作　　者：张志敏[1] 罗志宏[1] 谢立[1] 华清泉[1] 

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,湖北省武汉市430060

出　　处：《职业与健康》2012年第20期2556-2558,共3页Occupation and Health

摘　　要：目的比较在相同空腹血糖情况下,阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是否加重糖尿病患者的胰岛素抵抗(IR)。方法 60例合并不同程度OSAHS的男性糖尿病患者及同期入院的20例单纯糖尿病男性患者纳入研究,记录其年龄、体重质数(BMI)、空腹血糖(FBG)、胰岛素(INS)、呼吸暂停低通气指数(AHI)、嗜睡量表评分(ESS)、腰臀比(WHR),并接受了糖耐量(OGTT)试验。结果在相同空腹血糖的情况下,随着OSAHS严重程度的增加,INS、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感性检测指数(QUICKI)、胰岛素敏感指数(ISI)和OGTT曲线下面积(AUCOGTT)显示出差异性;但相对其他胰岛素敏感评价指数,HOMA-IR在不同程度的OSAHS患者中均存在差异性(HOMA中vs HOMA轻:5.17±0.93vs 4.05±0.57,P<0.01;HOMA重vs HOMA中:8.43±1.27 vs 5.17±0.93,P<0.01)。AUCOGTT也在不同程度的OSAHS患者中存在差异性(AUC中vs AUC轻:3 305.6±315.7 vs 2 924.7±251.4,P<0.01;AUC重vs AUC中:4 083.8±456.3 vs 3 305.6±315.7,P<0.01)。两者在IR的评估上更加灵敏。结论在相同空腹血糖的情况下,OSAHS将加重糖尿病患者的IR,IR随OSAHS程度的加剧而加重。[Objective]To study the influence of obstructive sleep apnea-hypopnea syndrome（OSAHS） on the development of insulin resistance（IR） in diabetes patients with the same fasting blood glucose.[Methods]A total of 60 diabetes male patients with OSAHS and 20 normal diabetes male inpatients were enrolled in this study.Their age,BMI,fasting blood glucose（FBG）,insulin（INS）,AHI,ESS score and WHR were recorded.All the patients received oral glucose tolerance test（OGTT）.[Results] Under the same fasting blood glucose,the INS,HOMA-IR,QUICKI,ISI and AUCOGTT showed statistical differences along with the increased degree of OSAHS.Compared to other insulin resistance indices,HOMA-IR showed differences in OSAHS patients with different degrees（HOMA moderate vs HOMA mild：5.17±0.93 vs 4.05±0.57,P0.01;HOMA severe vs HOMA moderate： 8.43±1.27 vs 5.17±0.93,P0.01）and so was the AUCOGTT（AUC moderate vs AUC mild： 3 305.6±315.7 vs 2 924.7±251.4,P0.01;AUC severe vs AUC moderate： 4 083.8±456.3 vs 3 305.6±315.7,P0.01）.Both of them were the more sensitive in IR evaluation.[Conclusion] Under the same fasting blood glucose,OSAHS will deteriorate the IR in diabetes patients and the IR state will aggravate along with the increased degree of OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 糖尿病 胰岛素抵抗 

分 类 号：R587[医药卫生—内分泌]