阻塞性睡眠呼吸暂停低通气综合征对2型糖尿病患者骨密度的影响  

Effects of obstructive sleep apnea hypopnea syndrome on the bone mineral density in patients with type 2 diabetes mellitus

作　　者：刘腾飞 陆强[2] 刘晓丽[2] 杨惠惠 杨帅 马宁[2] 贾晓娇[2] 尹福在[2] LIU Tengfei;LU Qiang;LIU Xiaoli(Hebei North College,Hebei,Zhangjiakou 075000,China;不详)

机构地区：[1]河北北方学院,河北省张家口市075000 [2]河北省秦皇岛市第一医院 [3]承德医学院

出　　处：《河北医药》2022年第8期1227-1229,共3页Hebei Medical Journal

摘　　要：目的探究2型糖尿病(T2DM)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者骨代谢状态。方法收集2020年9月至2021年4月住院的T2DM患者130例,根据睡眠呼吸暂停指数(AHI)分为单纯T2DM组、T2DM合并OSAHS组,其中女性患者分为A1和A2亚组,男性患者分为B1和B2亚组,测定血清钙、磷、碱性磷酸酶(ALP)、糖化血红蛋白(HbA1c)、25-OH维生素D3,测定受试者腰1~4骨密度(L1~4 BMD)、股骨颈骨密度(NFBMD)。分别比较男性组、女性组上述指标,并分析AHI与上述指标的相关性。结果A2与A1相比较,L1~4 BMD与NFBMD差异有统计学意义(P<0.05),钙、磷、ALP、25-OH维生素D3、HbA1c差异无统计学意义(P>0.05);B2与B1相比较,NFBMD差异有统计学意义(P<0.05),L1~4 BMD、钙、磷、ALP、25-OH维生素D3、HbA1c差异无统计学意义(P>0.05)。Pearson相关性分析表明T2DM合并OSAHS患者无论男性组还是女性组NFBMD均与AHI呈负相关(P<0.05)。结论OSAHS会进一步加剧T2DM患者骨代谢紊乱,且随着OSAHS的病情进展逐渐加重;T2DM合并OSAHS的患者NFBMD较L1~4 BMD能更好的反应骨代谢的状态。Objective To investigate the effects of obstructive sleep apnea hypopnea syndrome(OSAHS)on the bone metabolism status in patients with type 2 diabetes mellitus(T2DM).Methods A total of 130 patients with T2DM who were treated in our hospital from September 2020 to April 2021 were enrolled in the study,who were divided into simple T2DM group and T2DM combined OSAHS group according to Apnea Hypoventilation Index(AHI),moreover,the female patients were redivided into A1 group and A2 group,and the male patients were redivided into B1 group and B2 group.The levels of calcium phosphorus alkaline phosphatase(ALP),25-OH vitamin D3,glycosylated hemoglobin(HbA1c),and the bone mineral density(BMD)of lumbarspine(L1~4)as well as NFBMD were detected and compared between male group and female group.Moreover the correlation between AHI and above indexes was analyzed.Results There were significant differences in L1~4 BMD and NFBMD between A1 group and A2 group(P<0.05),however,there were no significant differences in the levels of calcium,phosphorus,ALP,25-OH vitamin D3 and HbA1c between the two groups(P>0.05).There were significant differences in NFBMD levels between B1 group and B2 group(P<0.05),however,there were no significant differences in the levels of L1~4 BMD,calcium,phosphorus,ALP,25-OH vitamin D3 and HbA1c between the two groups(P>0.05).Pearson correlation analysis showed that NFBMD was negatively correlated with AHI in both male patients and female patients with T2DM complicated by OSAHS(P<0.05).Conclusion OSAHS may further aggravate the disorder of bone metabolism in patients with T2DM,which may gradually aggravate with the progress of OSAHS,and the NFBMD is superior to L1~4 BMD in reflecting the state of bone metabolism.

关 键 词：2型糖尿病 阻塞性睡眠呼吸暂停低通气综合征 骨代谢 骨密度 

分 类 号：R587.1[医药卫生—内分泌]