OSAHS患者血清HIF-1α的表达及其与糖代谢紊乱的关系  

Relation between Hypoxia Inducible Factor-1 α and Glucose Metabolism in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：彭朝胜[1] 李丽华[2] 盛晓燕 曹悦鞍[1] 杨璐[1] 夏菁[1] 田力[1] 

机构地区：[1]中国人民解放军海军总医院特需医疗部,北京100048 [2]南昌大学附属三三四医院内科,330024

出　　处：《医学研究杂志》2017年第12期100-103,共4页Journal of Medical Research

摘　　要：目的观察阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血清低氧诱导因子(hypoxia inducible factor-1α,HIF-1α)的水平及其与该病糖代谢紊乱的关系。方法选取2014年2月~2016年12月笔者所在科室经多导睡眠图(PSG)检测明确OSAHS诊断的患者50例作为实验组(OSAHS组),同期健康体检者38例作为对照组(N组),均行72h动态血糖监测获取血糖波动情况,同时测定其血清HIF-1α和空腹胰岛素水平,并计算胰岛素抵抗指数(insulin resistance index,IRI)。结果 OSAHS组夜间血糖波动幅度(night mean amplitude glycemic excursions,NMAGE),HIF-1α及IRI较对照组明显升高(2.02±0.42 mmol/L vs 1.12±0.34 mmol/L,101.06±17.64 ng/L vs 46.48±8.50 ng/L和3.7±0.7 vs 2.1±0.4,P均<0.05);OSAHS组HIF-1α水平与呼吸暂停低通气指数(apnea hypoventilation index,AHI)、IRI及NMAGE呈正相关(分别r=0.314、0.346及0.368,P均<0.05)。结论 HIF-1α的高表达存在于OSAHS人群中,其高表达可能直接参与了OSAHS糖代谢紊乱的病理机制。Objective To investigate the relation ship between hypoxia inducible factor-1α（HIF-1α）and glucose metabolism in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods The survey was conducted in 88 patients selected from inpatient and outpatient patients of our department from Feb 2014 to Dec 2016.The 72h continuous glucose monitoring （CGM） and polysomnography（PSG） were determined. According to the result of PSG test,88 subjects were divided into two groups：obstructive sleep apnea hypopnea syndrome group（n=50）, normal control group （n=38）. The level of serum HIF-1αand fasting insulin were detected.The insulin resistance index（IRI） was calculated.Results In patients with obstructive sleep apnea hypopnea syndrome,the night mean amplitude glycemic excursions （NMAGE）,the level of serum HIF-1αand IRI were significantly higher than normal control group （2.02±0.42mmol/L vs 1.12±0.34mmol/L,101.06±17.64ng/L vs 46.48±8.50ng/L and 3.7±0.7 vs 2.1±0.4,all P〈0.05）. In the OSAHS group,the level of serum HIF-1α was positively correlated with AHI,IRIand NMAGE （r=0.314,0.346 and 0.368,all P〈0.05）.Conclusion There is high expression of HIF-1αand it may be directly involved in the pathogenesis of the disorder of glucose metabolism in patients with OSAHS.

关 键 词：阻塞性睡眠呼吸暂停 低通气综合征 低氧诱导因子 夜间血糖波动幅度 胰岛素抵抗 呼吸暂停低通气指数 

分 类 号：R5[医药卫生—内科学]