老年T2DM合并OSAS患者25(OH)D和血小板参数变化及与OSAS严重程度的相关性分析  

Changes of 25(OH)D and platelet parameters in elderly T2DM patients with OSAS and their correlation with the severity of OSAS

作　　者：甘玉燕 唐玫艳 张文 薛青 叶作东 唐宝佳 黄声志 Gan Yuyan;Tang Meiyan;Zhang Wen;Xue Qing;Ye Zuodong;Tang Baojia;Huang Shengzhi(Department of Respiratory and Critical Care Medicine,Ningde Hospital Affiliated to Ningde Normal College,Ningde,Fujian,352100,P.R.China)

机构地区：[1]宁德师范学院附属宁德市医院呼吸与危重症医学科,福建宁德352100

出　　处：《老年医学与保健》2022年第1期154-157,162,共5页Geriatrics & Health Care

摘　　要：目的探究老年2型糖尿病(T2DM)并阻塞性睡眠呼吸暂停综合征(OSAS)患者25羟基维生素D[25(OH)D]和血小板参数[平均血小板体积(MPV)和血小板分布宽度(PDW)]变化及与OSAS严重程度的相关性。方法选择2016年10月—2021年10月于宁德师范学院附属宁德市医院诊治的61例老年T2DM合并OSAS患者为观察组,50例单纯T2DM患者为对照组。观察并比较2组基线资料及血25(OH)D、MPV、PDW水平,以及OSAS严重程度不同的患者25(OH)D、MPV和PDW水平,采用Logistic回归模型分析OSAS的影响因素。结果 2组BMI、高血压史、冠心病史、糖化血红蛋白(HbA1c)、高密度脂蛋白胆固醇(HDL-C)和尿酸(UA)差异具有统计学意义(P<0.05);观察组MPV和PDW显著高于对照组(P<0.05),25(OH)D低于对照组(P<0.05);OSAS严重程度不同的患者间25 (OH)D和血小板参数差异具有统计学意义(P<0.05),其中25(OH)D随着OSAS严重程度的增高而降低(P<0.05),MPV、PDW随着OSAS严重程度的增高而上升(P<0.05);Logistic回归分析结果显示,冠心病史、HbA1c、25(OH)D、MPV和PDW是OSAS发生的影响因素(P<0.05)。结论老年T2DM合并OSAS患者MPV和PDW变化呈现上升趋势,25(OH)D呈下降趋势,其水平变化与T2DM合并OSAS发生和病情关系密切。Objective To investigate the changes of25 hydroxyvitamin D[25(OH)D]and platelet parameters[mean platelet volume(MPV)and platelet distribution width(PDW)]in elderly patients with type2 diabetes mellitus(T2 DM)complicated with obstructive sleep apnea syndrome(OSAS)and their correlation with the severity of OSAS.Methods 61 elderly patients with T2 DM complicated with OSAS treated in Ningde Hospital Affiliated to Ningde Normal College from October2016 to October2021 were selected as the observation group and50 patients with single T2 DM as the control group. The baseline data and levels of blood25(OH)D,MPV and PDW of the two groups were compared,and the levels of blood25(OH)D,MPV and PDW of patients with different severity of OSAS were compared. The influencing factors of OSAS were analyzed by logistic regression model. Results There were significant differences in BMI,history of hypertension,history of coronary heart disease,glycosylated hemoglobin(HbA1 c),high density lipoprotein cholesterol(HDL-C)and uric acid(UA)between the two groups(P< 0.05). MPV and PDW of the observation group were significantly higher than those of the control group(P< 0.05),and25(OH)D level was lower than that of the control group(P< 0.05). There was significant difference in25(OH)D level and platelet parameters among patients with different severity of OSAS(P< 0.05). Among them, 25(OH)D decreased with the increase of OSAS severity(P< 0.05),and MPV and PDW increased with the increase of OSAS severity(P< 0.05). Logistic regression analysis showed that the history of coronary heart disease,HbA1 c, 25(OH)D,MPV and PDW were the influencing factors of OSAS(P< 0.05).Conclusion The changes of MPV and PDW in elderly T2 DM patients with OSAS show an upward trend,and25(OH)D do a downward trend,and the changes of their levels were closely related to the occurrence and condition of T2 DM with OSAS.

关 键 词：老年 2型糖尿病 阻塞性睡眠呼吸暂停综合征 25羟基维生素D 平均血小板体积 血小板分布宽度 OSAS严重程度 相关性 

分 类 号：R766[医药卫生—耳鼻咽喉科] R587.2[医药卫生—临床医学]