2型糖尿病患者血清成纤维细胞生长因子与阻塞性睡眠呼吸暂停综合征的相关性  

The association study on the serum FGF21 of type 2 diabetic patients and obstructive sleep apnea hypopnea syndrome

作　　者：戴丽芬[1] 汪成[1] 李郑芳[1] 程晓亮[1] 

机构地区：[1]昆明医科大学第二附属医院内分泌科,云南昆明650101

出　　处：《云南医药》2015年第3期290-293,共4页Medicine and Pharmacy of Yunnan

摘　　要：目的探讨2型糖尿病(T2DM)患者血清成纤维细胞生长因子21(FGF21)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的关系。方法选取2014年住院的T2DM患者56例。根据患者P&D-9900睡眠呼吸记录分析系统仪监测结果,确定是否合并有OSAHS。将受试者分为:T2DM无OSAHS组24例、T2DM并OSAHS(T2DM+OSAHS)组32例。测定患者血糖、糖化血红蛋白、胰岛功能、血脂、FGF21水平等,计算胰岛素抵抗指数及胰岛素敏感指数,对结果进行相关分析。结果 1、T2DM无OSAHS组与T2DM+OSAHS组在血清FGF21水平上有差异(P<0.05),T2DM+OSAHS组的患者血清FGF21水平低于T2DM无OSAHS组的患者。2、T2DM+OSAHS组血清FGF21水平与AHI呈显著负相关(P<0.01)。3、T2DM+OSAHS组的C肽水平低于无OSAHS组(P<0.05)。4、FGF21与C肽的相关性分析,结果为显著正相关(P<0.01)。结论 1、T2DM患者合并OSAHS可影响FGF21的水平,对患者的血糖控制不利。动态监测T2DM患者血清FGF21的水平,或许可以对T2DM患者发生OSAHS的风险起到警示作用,而且可以反映OSAHS病情的进展程度,对T2DM患者防治OSAHS具有一定的临床意义。2、OSAHS引起血清FGF21水平的降低与C肽水平的降低是同步的,其原因可能与OSAHS造成的低氧血症、组织缺氧、氧化应激等所导致的胰岛功能的损害有关。Objective To investigate the association between serum fibroblast growth factor 21（FGF21） level in type 2 diabetic patients （T2DM） and the obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods To select 56 hospitalized patients with T2DM in 2014. To confirm whether the patients they suffered from OSAHS according to the P＆D-9900 sleep apnea recording then divide them into tow groups. The first group of 24 cases had simple T2DM, and the second group of 32 cases had not only T2DM but also OSAHS. Each patient was measured for fasting blood glucose, postprandial 2 hour blood glucose, glycosylated hemoglobin, pancreatic islet function, blood lipid, lipoprotein, the level of FGF21,the insulin resistance index and insulin sensitive index. The results were analyzed. Results 1. The levels of FGF21 in simple T2DM group and T2DM＋OSAHS group were different（P 〈 0.05）.The serum FGF21 level of the latter was lower than that of the former. 2. The serum FGF21 level between T2DM＋OSAHS group and AHI showed significantly negative correlation（P 〈 0.01）. 3. The level of C peptide of T2DM＋OSAHS group was lower than that of simple TEDM group（P 〈 0.05）. 4. FGF21＇s level and C peptide＇s level showed significantly positive correlation （P 〈 0.01）. Conclusion 1. Serum FGF21 level can be affected when T2DM patients complicated with OSAHS. To monitor serum FGF21 level closely may be a warning to patients at risk of OSAHS and can reflect the severity of OS- AHS. It is of certain significance for the prevention and treatment of OSAHS. 2. The decrease of FGF21 level induced by OSAHS is synchronous with the decrease of C peptide level.

关 键 词：2型糖尿病 成纤维细胞生长因子 21阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R587.1[医药卫生—内分泌]