阻塞性睡眠呼吸暂停合并血糖异常患者血清脂联素水平分析  

Serum Adiponectin Levels in Patients With Obstructive Sleep Apnoea and Dysglycemia

作　　者：左黎昀[1] 齐彩霞[1] 刘宏[1] 郭尚德[1] 张义平[1] 甄琪[2] 赵海波[2] 

机构地区：[1]山西大同大学呼吸病与职业病研究所,山西大同大学医学院,山西省大同市037009 [2]山西大同大学医学院临床医学系

出　　处：《中国全科医学》2016年第8期912-915,共4页Chinese General Practice

基　　金：山西省高等学校大学生创新创业训练项目(2013275);山西大同大学校级科研基金(2010K2)

摘　　要：目的探讨阻塞性睡眠呼吸暂停(OSA)合并血糖异常患者的血清脂联素水平变化。方法选取2010年6月—2013年6月在山西大同大学附属医院呼吸科接受多导睡眠呼吸监测的男性OSA患者129例(OSA组),其中1年内新诊断糖尿病41例(DM组),葡萄糖调节受损29例(IGR组),血糖正常59例(NG组);同时选取30例健康男性作为对照(NC组)。所有受试者采用ELISA法测定血清脂联素,并比较各组的血清脂联素水平及分析低脂联素血症的危险因素。结果各组间年龄、体质指数(BMI)比较,差异无统计学意义(P>0.05)。NG组、IGR组和DM组的空腹血糖和胰岛素抵抗指数均高于NC组,差异均有统计学意义(P<0.05);DM组的空腹血糖高于IGR组,差异有统计学意义;DM组的高密度脂蛋白低于NC组,差异有统计学意义(P<0.05)。IGR组和DM组的三酰甘油均高于NC组,差异均有统计学意义(P<0.05);DM组和IGR组的空腹血糖、胰岛素抵抗指数、三酰甘油、呼吸暂停低通气指数及血氧饱和度低于90%的时间占总睡眠时间的百分比高于NG组,最低血氧饱和度、血清脂联素低于NG组,差异均有统计学意义(P<0.05);NG组、IGR组和DM组的血清脂联素均低于NC组,差异均有统计学意义(P<0.05)。OSA组的相关分析显示,BMI(r=-0.248,P=0.005)、腰臀比(r=-0.476,P<0.001)、空腹血糖(r=-0.374,P<0.001)、胰岛素抵抗指数(r=-0.546,P<0.001)、胆固醇(r=-0.253,P=0.004)、三酰甘油(r=-0.287,P=0.001)、呼吸暂停低通气指数(r=-0.710,P<0.001)、夜间血氧饱和度低于90%时间占总睡眠时间百分比(r=-0.521,P<0.001)与血清脂联素呈负相关;高密度脂蛋白、夜间最低血氧饱和度与血清脂联素正相关(r=0.294,P<0.001;r=0.651,P<0.001)。多元逐步回归分析显示,呼吸暂停低通气指数是男性OSA患者发生低血清脂联素血症的独立危险因素(P<0.05)。结论 OSA合并血糖异常患者血清脂联素水平降低,检测血清脂联素,有利于早期发现男性OSA患者的2Objective To explore the changes of serum adiponectin levels in patients with obstructive sleep apnoea（ OSA） and dysglycemia. Methods We enrolled 129 male OSA patients who received the monitor of polysomnography in the Respiratory Department of Shanxi Datong University Hospital from June 2010 to June 2013. The 129 subjects were assigned into OSA group,among which 41 subjects（ DM group） were diagnosed with diabetes within one year,29 patients were diagnosed with impaired glucose regulation（ IGR group） and 59 patients（ NG group） had normal blood glucose. We also enrolled 30 healthy male subjects as NC group. Serum adiponectin level was determined using ELISA method,and comparison was made in serum adiponectin level among each group. Risk factors for hypoadiponectinemia were analyzed. Results The groups were not significantly different in age and BMI（ P〈0. 05）. NG group, IGR group and DM group were higher（ P〈0. 05） than NC group in fasting blood glucose（ FBG） and HOMA-IR; DM group was higher（ P〈0. 05） than IGR group in FBG; DM group was lower（ P〈0. 05） than NC group in HDL; IGR group and DM group were higher than NC group in TG（ P〈0. 05）; DM group and IGR group were higher in FBG,HOMA-IR,TG,AHI and CT90 and were lower in LSa O2 and serum adiponectin level than NG group（ P〈0. 05）; NG group,IGR group and DM group were lower than NC group in serum adiponectin level（ P〈0. 05）. Correlation analysis of OSA group showed that BMI（ r =- 0. 248,P = 0. 005）,WHR（ r =- 0. 476,P〈0. 001）,FBG（ r =- 0. 374,P〈0. 001）,HOMA-IR（ r =- 0. 546,P〈0. 001）,cholesterol（ r =- 0. 253,P = 0. 004）,TG（ r =- 0. 287,P = 0. 001）,AHI（ r =- 0. 710, P〈0. 001）, CT90（ r =- 0. 521, P〈0. 001） had negative correlation with serum adiponectin level; HDL and LSa O2 had positive correlation with serum adiponectin level（ r = 0. 294,P〈0. 001; r =0. 651,P〈0. 001）. Multivariate regression analysis showed that was an independent risk factor for low serum adi

关 键 词：睡眠呼吸暂停 阻塞性 血糖异常 脂联素 

分 类 号：R587.1[医药卫生—内分泌]