阻塞性睡眠呼吸暂停低通气综合征与代谢综合征的相关性研究  

Association between obstructive sleep apnea hypopnea syndrome and metabolic syndrome

作　　者：魏嘉洁[1] 矫杰[1] 周迎生[1] 魏永祥[3] 房芳[2] WEI Jiajie;JIAO Jie;ZHOU Yingsheng;WEI Yongxiang;FANG Fang(Department of Endocrinology and Metabolism, Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases, Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所内分泌代谢科,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所睡眠医学中心,100029 [3]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所耳鼻喉科,100029

出　　处：《心肺血管病杂志》2019年第8期838-842,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与代谢综合征(MS)及其组分之间的相关性。方法:本研究为回顾性研究,选取2008年1月至2018年8月,北京安贞医院收治的1 042例行多导睡眠监测的患者,总OSAHS组842例,并按睡眠呼吸暂停低通气指数(AHI)分为三个亚组,分别为轻度OSAHS组320例、中度OSAHS组224例、重度OSAHS组298例;入选AHI<5且年龄、性别与OSAHS组相匹配的患者为对照组(200例)。所有患者均测身高、体质量、腰围、血压,并检测FPG、血脂、尿酸、肝肾功能、Hb Alc等指标。结果:OSAHS各组的MS患病率均明显高于对照组,且重度组明显高于轻度组(P<0. 05),随着OSAHS程度的加重,伴有多个(≥3个) MS的组分的比例也逐渐增加。AHI与MS、腹型肥胖、高血压、血脂异常均呈明显正相关(r=0. 243、0. 211、0. 125、0. 196,P <0. 01)。总OSAHS组患者的MS患病风险是对照组的3倍(OR=3. 077)。轻、中、重OSAHS组患MS的风险分别是对照组的2. 1倍、3. 4倍、4. 7倍(OR=2. 084,3. 426,4. 691)。多因素Logistic回归分析中,OSAHS进入方程(OR=1. 638,P<0. 05)。结论:OSAHS与MS密切相关,是MS的危险因素之一。Objective: To analyze the association between obstructive sleep apnea hypopnea syndrome ( OSAHS) and metabolic syndrome. Methods: The polysomnography was performed for diagnosing OSAHS. Totally,842 patients diagnosed with OSAHS by polysomnography between January 2008 and August 2018 were stratified to be mild,moderate and severe as per the value of AHI.Two hundred age,sex matched subjects served as a control group( AHI<5).Blood pressure,height,waist circumference and body weight were measured in all cases. Levels of HbA1c,fasting blood glucose,blood lipid,liver and kidney function indexes were tested. Results: The prevalence of MS in OSAHS group was significantly higher than that in control group,and in severe group was significantly higher than that in mild group( P<0. 05). As the severity of OSAHS increased,the proportion of metabolic abnormalities with more than three components increased gradually. AHI was positively correlated with metabolic syndrome,abdominal obesity,hypertension,dyslipidemia ( r = 0. 243,0. 211,0. 125,0. 196,P<0. 01). Univariate Logistic analysis showed that the Odds ration of MS in OSAHS group was about three times higher than that in control group ( OR= 3. 077). The risk of MS in light,medium and heavy OSAHS group was 2. 1,3. 4 and 4. 7 times higher than that in control group ( OR = 2. 084,3. 426,4. 691). Multivariate logistic regression analysis showed that OSAHS was an independent risk factor for metabolic syndrome ( OR = 1. 638,P < 0. 05 ). Conclusions: OSAHS is closely related to MS,and is one of the independent risk factors for MS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 代谢综合征 多导睡眠监测 心血管疾病 

分 类 号：R56[医药卫生—呼吸系统]