2型糖尿病合并阻塞性睡眠呼吸暂停综合征的临床特征及其危险因素  

Clinical characteristics and risk factors of obstructive sleep apnea syndrome in patients with type 2 diabetes mellitus

作　　者：魏嘉洁[1] 矫杰[1] 周迎生[1] Wei Jiajie;Jiao Jie;Zhou Yingsheng(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内分泌代谢科北京市心肺血管疾病研究所

出　　处：《首都医科大学学报》2020年第1期35-39,共5页Journal of Capital Medical University

基　　金：国家自然科学基金(81641027);北京市科学技术委员会课题(Z131100004013044);北京市卫生系统高层次卫生技术人才培养计划资助项目(2013-2-006)~~

摘　　要：目的研究2型糖尿病患者阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的临床特点及危险因素。方法选取2012年至2019年首都医科大学附属北京安贞医院收治的2型糖尿病合并OSAHS的225例患者为病例组(OSAHS组),未合并OSAHS的患者76例为对照组。所有患者均测身高、体质量,并计算体质量指数、腰围、收缩压、舒张压,并检测肝肾功能、尿酸、血糖、血脂、糖化血红蛋白等指标。结果OSAHS组与对照组相比,腰围、体质量指数、尿酸、糖化血红蛋白明显升高(P<0.05或0.01),高血压、冠状动脉粥样硬化性心脏病(以下简称冠心病)的患病率明显升高(P<0.05),高密度脂蛋白胆固醇明显降低(P<0.01)。以2型糖尿病患者是否合并OSAHS为因变量,进行多因素Logistic分析。结果显示,冠心病史、腰围、尿酸、高密度脂蛋白胆固醇、糖化血红蛋白是2型糖尿病患者合并OSAHS的危险因素。结论2型糖尿病患者具有冠心病史、腰围增大、尿酸浓度高、高密度脂蛋白胆固醇浓度低、糖化血红蛋白浓度高等特征则合并OSAHS的风险增大。Objective To study the clinical characteristics and risk factors of obstructive sleep apnea syndrome(OSAHS)in patients with type 2 diabetes mellitus(T2DM),and analysis the correlation.Methods Patients were divided into OSAHS group(225 cases)and non-OSAHS group(76 cases)in Beijing Anzhen Hospital,Capital Medical University from 2012 to 2019.Height,body weight,body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP)and diastolic blood pressure(DBP)were measured in all cases.Fasting plasma glucose(FPG),hemoglobin A1c(HbA1c),blood lipid,uric acid(UA),liver and kidney function indexes were tested.Result Compared with the non-OSAHS group,WC,BMI,UA,and HbA1c levels were significantly increased(P<0.05 or 0.01).Compared with the non-OSAHS group,the prevalence of hypertension and coronary heart disease was significantly increased(P<0.05),and high density lipoprotein cholesterol(HDL-C)was significantly decreased(P<0.01).Multivariate Logistic analysis was performed with OSAHS in T2DM patients as the dependent variable.The results showed that the history of coronary heart disease,WC,UA,HDL-C and HbA1c were the risk factors for T2DM combined with OSAHS.Conclusions T2DM patients have a history of coronary heart disease,increased waist circumference,high uric acid level,low HDL-C level and high HbA1c,which increase the risk of OSAHS.

关 键 词：2型糖尿病 阻塞性睡眠呼吸暂停低通气综合征 多导睡眠监测 冠状动脉粥样硬化性心脏病 

分 类 号：R587[医药卫生—内分泌]