阻塞性睡眠呼吸暂停低通气综合征患者血清瘦素和脂联素检测及临床分析  

Detect and clinical analysis of the serum leptin and adiponectin levels in patients with obstructive sleep apnea hypopnea syndrome

作　　者：文娟[1] 张大为[1] 明昊[1] 毛圆[1] 马骏[1] 蒋帅[1] 陈仁杰[1] 

机构地区：[1]江苏南京医科大学第二附属医院耳鼻咽喉头颈外科,南京210011

出　　处：《中国中西医结合耳鼻咽喉科杂志》2015年第2期104-108,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的检测阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与非OSAHS患者血清瘦素和脂联素水平,分析与体重指数（BMI）、血压、空腹血糖等一般生理指标及呼吸暂停低通气指数（AHI）等多导睡眠仪（PSG）参数的关系,探讨临床意义。方法研究对象为新诊断的OSAHS患者33例和非OSAHS对照15例。PSG监测结束后,上午8：00~9：00抽取空腹静脉血,ELISA法检测瘦素和脂联素。结果 OSAHS患者中瘦素水平（11.2±12.2 ng/m L）高于对照组（3.8±1.8 ng/m L）,脂联素水平（6.13±1.16μg/m L）低于对照组（8.51±3.84μg/m L）,差异均有统计学意义（P〈0.05）。皮尔森分析示瘦素与BMI（r=0.68,P〈0.05）、颈围（r=0.516,P〈0.05）、腰围（r=0.531,P〈0.05）、AHI（r=0.198,P〈0.05）呈正相关;脂联素与BMI（r=-0.342,P〈0.01）、颈围（r=-0.324,P〈0.05）、腰围（r=-0.357,P〈0.05）、AHI（r=-0.247,P〈0.05）呈负相关。OSAHS患者中糖尿病与高血压人群的瘦素水平（糖尿病患者14.2±8.2 ng/m L,高血压患者13.8±6.4 ng/m L）高于该人群中未患两种疾病的人群（非糖尿病患者11.8±6.8 ng/m L,非高血压患者10.8±2.1 ng/m L）,而脂联素水平前者（糖尿病患者3.83±2.03μg/m L,高血压患者3.01±1.06μg/m L）低于后者（非糖尿病患者5.31±1.84μg/m L,非高血压患者5.48±2.06 ug/m L）,差异均有统计学意义（P〈0.05）。结论 OSAHS患者血清中的瘦素水平升高,脂联素水平降低;瘦素的含量与患者肥胖程度及OSAHS的严重程度呈正相关,但脂联素呈负相关。血清中瘦素水平的升高可能参与OSAHS高血压并发症的发生,OSAHS糖尿病患者比例的增加可能与血清中脂联素表达的降低有关。Objective To evaluate the serum leptin and adiponectin levels in OSAHS patients and their possible relation with obesity, blood pressure, fasting blood-glucose and apnea-hypopnea index（AHI）, then analyze the clinical significance in their relationship. Methods Thirty-three newly untreated diagnosed OSAHS patients（AHI≥5） and 15 non-OSAHS（AHI5） were studied.To confirm the diagnosis, all patients underwent standard polysomnography in our sleep disorders center. Serum samples were taken at08：00-09：00 in the morning after overnight fasting. Results The serum leptin levels in OSAHS patients（11.2 ±12.2 ng/m L） were significantly higher than those in controls（3.8±1.8 ng/m L, P〈0.05）, and the serum adiponectin levels in OSAHS patients（6.13±1.16μg/m L） were significantly lower than those in controls（8.51±3.84 μg/m L, P〈0.05）. Spearman＇s correlation suggests that serum leptin levels were positively correlated with BMI（r=0.68, P〈0.05）, neck circumference（r=0.516, P〈0.05）, weight circumference（r=0.531, P〈0.05） and AHI（r=0.198, P〈0.05） in OSAHS patients, while the serum adiponectin levels were negatively correlated with BMI（r=-0.342, P〈0.05）, neck circumference（r=-0.324, P〈0.05）, weight circumference（r=-0.357, P〈0.05） and AHI（r=-0.247, P〈0.05）. The leptin levels in OSAHS patients who also have diabetes mellitus and hypertension were higher（OSAHS patients with diabetes mellitus： 14.2 ±8.2 ng/m L,OSAHS patients with hypertension： 13.8 ±6.4 ng/m L） than the other patients who have not the two disease（OSAHS patients without diabetes mellitus： 11.8±6.8 ng/m L, OSAHS patients without hypertension： 10.8±2.1ng/m L）. But as to the adiponectin levels, it have a reverse relationship, the former were as follows（OSAHS patients with diabetes mellitus： 3.83±2.03 μg/m L, OSAHS patients with hypertension： 3.01 ±1.06μg/m L）, the latter were as follows（OSAHS patients without diabetes mellitus： 5.31 ±1.84 μg/m L, OSA

关 键 词：阻塞性睡眠呼吸暂停低 瘦素 脂联素 肥胖 

分 类 号：R766[医药卫生—耳鼻咽喉科]