阻塞性睡眠呼吸暂停综合征对男性患者血清中脂联素和脂蛋白水平的影响  

Impact of obstructive sleep apnea syndrome on the concentration of adiponectin,lipoproteins in serum

作　　者：曹娟[1] 王愿[1] 黄丽蓉[1] 庄少侠[1] 蔡培泉[1] 卞涛[1] 

机构地区：[1]南京医科大学附属无锡市人民医院呼吸内科,江苏无锡214023

出　　处：《南京医科大学学报（自然科学版）》2016年第4期449-451,465,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南京市科技发展计划项目(200901093)

摘　　要：目的 :探讨男性阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者脂联素(adiponectin,ADPN)水平和高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的变化情况。方法 :选择单纯打鼾患者和OSAS患者共计103例,受试者均为男性。按照睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI,次/h)将所有受试者分为4组,即对照组(n=21,AHI≤5次/h),轻度OSAS组(n=25,5次/h<AHI≤20次/h),中度OSAS组(n=42,20次/h<AHI≤40次/h)以及重度OSAS组(n=15,AHI>40次/h)。监测整晚的AHI和血氧饱和度(SpO_2),并测定血清中ADPN、HDL-C和LDL-C浓度。结果 :与对照组相比,各个OSAS组受试者间年龄无显著性差异(P>0.05),各OSAS组受试者的AHI均明显高于对照组(P<0.01);最低SpO_2和ADPN水平明显低于对照组(P<0.05,P<0.01)。轻度OSAS组血清中HDL-C和LDL-C水平与对照组相比差异不明显(P>0.05);中度和重度OSAS患者HDL-C明显降低,LDL-C显著升高(P<0.05,P<0.01)。OSAS患者AHI与血清中ADPN(r=-0.521,P<0.01)和HDL-C(r=-0.344,P<0.05)的浓度呈负相关,与LDL-C呈正相关(r=0.326,P<0.05);而最低SpO_2与ADPN(r=0.519,P<0.01)和HDL-C(r=0.337,P<0.05)呈正相关,与LDL-C呈负相关(r=-0.309,P<0.05)。结论 :OSAS可以降低男性患者血清中ADPN和HDL-C的浓度,升高LDL-C的水平,该作用与OSAS患者AHI的升高和最低SpO_2的降低密切相关。Objective：To investigate the changes of adiponectin（ADPN）,high density lipoprotein-cholesterol（HDL-C） and low density lipoprotein-cholesterol（LDL-C） level in male patients with obstructive sleep apnea syndrome（OSAS）. Methods：103 habitual snorers,participated in the study voluntarily. All the patients were male. All the patients were divided into 4 groups,according to apnea hypopnea index（AHI）. There were simple snorers group（vehicle,n=21,AHI≤5）,mild OSAS group（n=25,5AHI≤20）,moderate OSAS group（n=42,20AHI≤40） and severe OSAS group（n=15,AHI40）. AHI and transcutaneous saturation oxygen（SpO2） were mornitored during the whole night and the concentration of APDN,HDL-C and LDL-C in serum were evaluated in the next morning.Results：There was no significant difference of age among the four groups（P〉0.05）. Compared with vehicle,AHI in all three OSAS groups increased obviously（P〈0.01）,while min SpO2 decreased markedly（P〈0.01）. Compared with vehicle,however there was a trend to change of HDL-C and LDL-C in mild OSAS group,ANOVA did not show any significance（P〉0.05）. Compared with vehicle,HDL-C decreased significantly and LDL-C increased obviously in moderate and severe OSAS group（P〈0.05,P〈0.01）. In OSAS patients,AHI was negatively correlated with ADPN（r=-0.521,P〈0.01） and HDL-C（r=-0.344,P〈0.05） significantly,while it was positively correlated with LDL-C（r=0.326,P〈0.05） markedly. min SpO2 was positively correlated with ADPN（r=0.519,P〈0.01）and HDL-C（r=0.337,P〈0.05） significantly,while it was negatively correlated with LDL-C（r=-0.309,P〈0.05） obviously. Conclusion：OSAS can lower the concentration of ADPN and HDL-C,meanwhile it can elevate LDL-C in serum. The effect is associated with the in-creased AHI and decreased min SpO2.

关 键 词：阻塞性睡眠呼吸暂停综合征 呼吸暂停低通气指数 血氧饱和度 脂联素 高密度脂蛋白胆固醇 低密度脂蛋白胆固醇 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]