超重肥胖对阻塞性睡眠呼吸暂停相关高血压人群糖代谢的影响  

The effect of obesity on the glycometabolism in obstructive sleep apnea-related hypertension

作　　者：屈娇 姚晓光[2] 李南方[2] 努尔古丽·买买提[2] 王磊[2] QU Jiao;YAO Xiaoguang;LI Nanfang;MAIMAITI Nuerguli;WANG Lei(Xinjiang Clinical College ofAnhui Medical University,Xinjiang,Urumqi,830001,China;Center of Diagnosis,Treatment and Research of Hypertension,People's Hospital of Xinjiang,Xinjiang,Urumqi,830001,China)

机构地区：[1]安徽医科大学新疆临床学院,新疆乌鲁木齐830001 [2]新疆维吾尔自治区人民医院高血压中心,新疆高血压研究所,新疆乌鲁木齐830001

出　　处：《新疆医学》2020年第1期23-27,共5页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区医学联合基金项目(项目编号:2016D01C114)。

摘　　要：目的2型糖尿病(T2DM)在阻塞性睡眠呼吸暂停(OSA)相关性高血压人群中的发病率目前尚不明确,超重肥胖对这类人群糖代谢的影响尚未报道,旨在探讨超重肥胖对OSA相关性高血压人群发生T2DM风险的影响。方法连续入选2010年1月-12月就诊新疆维吾尔自治区人民医院高血压中心的高血压患者,根据排除标准最终纳入611例,所有患者进行夜间多导睡眠呼吸监测。本研究为队列研究,平均随访时间为4.5(3.0,7.0)年,共获得491例随访患者,在BMI<25 kg/m^2人群中,非OSA组46人,OSA组50人,在BMI≥25 kg/m^2人群中,非OSA组96人,OSA组299人。结果超重肥胖患者(BMI≥25 kg/m^2)中,OSA组糖化血红蛋白水平较高(P值<0.001),且OSA组T2DM的发病率明显高于非OSA组(19.1%vs.9.4%,P=0.027)。Cox比例风险模型结果显示超重肥胖患者T2DM的发病风险是普通高血压患者的两倍以上(HR:2.226;95%CI,1.323-3.747;P=0.003)。结论OSA相关性高血压人群中,T2DM的发病率为17.8%,合并超重肥胖的患者T2DM发病风险是普通高血压患者的2倍。Objective The incidence of type 2 diabetes mellitus(T2DM)in obstructive sleep apnea(OSA)-related hypertension population is not yet clear,and the effect of overweight and obesity on glucose metabolism in this population hasn’t been reported.So this study aims to explore the effect of overweight and obesity on the risk of T2DM in OSA-related hypertension population through a cohort.Methods 895 patients hospitalized in People’s Hospital of Xinjiang from January to December 2010 were selected as research objects.Finally,611 patients were included and monitored by polysomnography according to the exclusion criteria.The average follow-up time is4.5(3.0,7.0)years.491 patients are finally followed up,including 349 OSA patients and 142 non-OSA patients.Among them,There were 46 cases of non-OSA patients and 50 cases of OSA patients,who both had BMI<25 kg/m^2.While there were 96 cases of non-OSA patients and 299 cases of OSA patients who had BMI≥25 kg/m^2,Results Among overweight and obese patients(BMI>25 kg/m^2),the glycosylated hemoglobin level in the OSA group was higher than that in the non-OSA group(P<0.001),and the incidence of T2DM in the OSA group was significantly higher than that in the non-OSA group(19.1%vs.9.4%,P=0.027).Cox proportional hazard model showed that the risk of T2DM in overweight and obese patients was more than twice that in other hypertensive patients(HR:2.226;95%CI,1.323-3.747;P=0.003).Conclusion Among OSA-related hypertension patients,the incidence of T2DM is 17.8%,and the risk of T2DM in patients with overweight and obesity is twice higher than that of common hypertension patients.

关 键 词：阻塞性睡眠呼吸暂停相关性高血压 糖尿病 超重肥胖 发病率 

分 类 号：R587.1[医药卫生—内分泌]