2型糖尿病合并OSAHS患者AHI与同型半胱氨酸和肝酶的相关性  

Correlation between apnea hypopnea index and homocysteine,liver enzymes in type 2 diabetes mellitus patients with obstructive sleep apnea hypopnea syndrome

作　　者：路彦辉 王锐[2] 马春明[2] 田伊茗[2] 刘腾飞 尹福在[2] LU Yanhui;WANG Rui;MA Chunming(不详;2020 Master Student of Hebei North University,Hebei,Zhangjiakou 075000,China)

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

出　　处：《河北医药》2023年第7期1043-1046,共4页Hebei Medical Journal

摘　　要：目的探讨2型糖尿病(T2DM)合并睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠呼吸暂停低通气指数(AHI)与同型半胱氨酸(Hcy)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)之间的关系研究。方法选取住院T2DM患者216例,依据AHI分为A组单纯T2DM(AHI<5共49例);B1组T2DM合并轻、中度OSAHS(AHI 5~30共119例);B2组T2DM合并重度OSAHS(AHI>30共48例),分析AHI与Hcy、肝酶的关系。结果Hcy水平B2组高于B1组和A组,组间比较差异均有统计学意义(P<0.05);B1组较A组Hcy水平有升高趋势,但组间比较差异无统计学意义(P>0.05)。GGT水平B2组高于B1组,B1组高于A组,3组间两两比较差异均有统计学意义(P<0.05)。ALT水平B2组高于B1组和A组,组间比较差异均有统计学意义(P<0.05);B1组较A组ALT水平有升高趋势,但组间比较差异无统计学意义(P>0.05)。随AHI升高3组AST水平有升高趋势,但3组间两两比较差异均无统计学意义(P>0.05)。分别以Hcy、GGT、ALT、AST为因变量,行多元线性回归分析,结果显示AHI与T2DM合并OSAHS患者Hcy、GGT独立相关。结论OSAHS会致T2DM患者Hcy及肝酶水平升高,AHI是Hcy、GGT的独立危险因素,提示OSAHS增加T2DM患者心脑血管疾病风险及早期肝损伤,T2DM患者应重视OSAHS筛查和治疗并适时补充叶酸。Objective To investigate the correlation between apnea hypopnea index(AHI)and homocysteine(Hcy),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyltranspeptidase(GGT)in type 2 diabetes mellitus(T2DM)patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 216 T2DM patients were enrolled in the study,and divided into A group(T2DM patients with AHI<5,n=49),B1 group(T2DM patients with mild and moderate OSAHS with AHI of 5~30,n=119)and B2 group(T2DM patients with severe OSAHS with AHI>30,n=48).The correlation between AHI and Hcy,liver enzymes was analyzed.Results Hcy level was significantly higher in B2 group than that in B1 group and A group(P<0.05),which was higher in B1 group than that in A group,although no significant difference was detected(P>0.05).GGT level was significantly higher in B2 group than that in B1 group and A group,which was significantly higher in B1 group than that in A group(P<0.05).ALT level was significantly higher in B2 group than that in B1 group and A group(P<0.05),which was higher in B1 group than that in A group,although no significant difference was detected(P>0.05).AST level increased with the increase in AHI,although no significant difference was detected among the three groups(P>0.05).Multiple linear regression analysis with Hcy,GGT,ALT,and AST as dependent variables showed that AHI was independently correlated with Hcy and GGT levels in T2DM patients with OSAHS.Conclusion OSAHS can increase the levels of Hcy and liver enzymes in T2DM patients.AHI is an independent risk factor for Hcy and GGT,suggesting that OSAHS increases the risk of cardiovascular and cerebrovascular disease and early liver injury in T2DM patients.Screening and treatment of OSAHS and supplement of folic acid timely should be concerned in T2DM patients.

关 键 词：2型糖尿病 睡眠呼吸暂停低通气综合征 睡眠呼吸暂停低通气指数 同型半胱氨酸 丙氨酸氨基转移酶 

分 类 号：R587.1[医药卫生—内分泌]