国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2012年
13期
981-984
,共4页
杨夏%武月青%范艳锋%王蓓%刘卓拉
楊夏%武月青%範豔鋒%王蓓%劉卓拉
양하%무월청%범염봉%왕배%류탁랍
阻塞性睡眠呼吸暂停低通气综合征%胰高血糖素样肽-1
阻塞性睡眠呼吸暫停低通氣綜閤徵%胰高血糖素樣肽-1
조새성수면호흡잠정저통기종합정%이고혈당소양태-1
Obstructive sleep apnea-hypopnea syndrome%Glucagon-like peptide-1
目的 观察阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者血清胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)的变化,探讨OSAHS引起糖代谢异常的可能发病机制.方法 选取OSAHS患者50例,分为轻度组11例,中度组13例,重度组26例.选取OSAHS合并2型糖尿病患者12例,单纯2型糖尿病患者14例及单纯肥胖者16例.行整夜多导睡眠监测,监测次日测定空腹血糖、空腹GLP-1水平、餐后1 h GLP-1水平及胰岛素水平,比较各组间差异,并行相关性分析.结果 重度组、OSAHS合并糖尿病组和单纯2型糖尿病组中GLP-1差值(餐后1h与餐前之差)及餐后胰岛素水平与其他各组相比,差异有统计学意义(P＜0.05).OSAHS合并糖尿病组与单纯糖尿病组相比,差异有统计学意义(P＜0.05).相关分析显示OSAHS患者餐后GLP-1升高幅度与呼吸暂停低通气指数、最低血氧饱和度及餐后胰岛素水平之间均存在相关性(r值为-0.427、0.467、0.359,P＜0.001).结论 随着病情的加重,OSAHS患者餐后GLP-1升高幅度降低,并且与胰岛素合成和分泌下降相关,这提示GLP-1可能在OSAHS导致糖代谢异常的发生、发展中起一定作用.
目的 觀察阻塞性睡眠呼吸暫停低通氣綜閤徵(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者血清胰高血糖素樣肽-1(glucagon-like peptide-1,GLP-1)的變化,探討OSAHS引起糖代謝異常的可能髮病機製.方法 選取OSAHS患者50例,分為輕度組11例,中度組13例,重度組26例.選取OSAHS閤併2型糖尿病患者12例,單純2型糖尿病患者14例及單純肥胖者16例.行整夜多導睡眠鑑測,鑑測次日測定空腹血糖、空腹GLP-1水平、餐後1 h GLP-1水平及胰島素水平,比較各組間差異,併行相關性分析.結果 重度組、OSAHS閤併糖尿病組和單純2型糖尿病組中GLP-1差值(餐後1h與餐前之差)及餐後胰島素水平與其他各組相比,差異有統計學意義(P＜0.05).OSAHS閤併糖尿病組與單純糖尿病組相比,差異有統計學意義(P＜0.05).相關分析顯示OSAHS患者餐後GLP-1升高幅度與呼吸暫停低通氣指數、最低血氧飽和度及餐後胰島素水平之間均存在相關性(r值為-0.427、0.467、0.359,P＜0.001).結論 隨著病情的加重,OSAHS患者餐後GLP-1升高幅度降低,併且與胰島素閤成和分泌下降相關,這提示GLP-1可能在OSAHS導緻糖代謝異常的髮生、髮展中起一定作用.
목적 관찰조새성수면호흡잠정저통기종합정(obstructive sleep apnea-hypopnea syndrome,OSAHS)환자혈청이고혈당소양태-1(glucagon-like peptide-1,GLP-1)적변화,탐토OSAHS인기당대사이상적가능발병궤제.방법 선취OSAHS환자50례,분위경도조11례,중도조13례,중도조26례.선취OSAHS합병2형당뇨병환자12례,단순2형당뇨병환자14례급단순비반자16례.행정야다도수면감측,감측차일측정공복혈당、공복GLP-1수평、찬후1 h GLP-1수평급이도소수평,비교각조간차이,병행상관성분석.결과 중도조、OSAHS합병당뇨병조화단순2형당뇨병조중GLP-1차치(찬후1h여찬전지차)급찬후이도소수평여기타각조상비,차이유통계학의의(P＜0.05).OSAHS합병당뇨병조여단순당뇨병조상비,차이유통계학의의(P＜0.05).상관분석현시OSAHS환자찬후GLP-1승고폭도여호흡잠정저통기지수、최저혈양포화도급찬후이도소수평지간균존재상관성(r치위-0.427、0.467、0.359,P＜0.001).결론 수착병정적가중,OSAHS환자찬후GLP-1승고폭도강저,병차여이도소합성화분비하강상관,저제시GLP-1가능재OSAHS도치당대사이상적발생、발전중기일정작용.
Objective To study the changes of serum glueagon-like peptide-1 (GLP-1) levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),and then explore the morbidity mechanism of glucose metabolism disorder caused by OSAHS.Methods To select 50 patients with OSAHS,these patients were divided into mild group (11 cases),moderate group (13 cases) and severe group (26 cases).To select 12 OSAHS patients with type 2 diabetes,14 patients with type 2 diabetes and 16 simple obesity patients.All patients received polysomnogram monitoring all night.Then in the next morning,fasting blood glucose,fasting GLP-1,1-hour postprandial GLP-1 and insulin level were measured.To compare the difference and correlation among each group.Results The GLP-1 level and postprandial insulin level in severe group,the OSAHS patients with type 2 diabetes group and the simple type 2 diabetes group were significantly different with the control group,mild group and moderate group ( P ＜0.05).The OSAHS patients with type 2 diabetes group was different with the simple type 2 diabetes group ( P ＜0.05).The GLP-1 level was related with AHI,LSaO2,postprandial insulin level( r =-0.427,0.467,0.359,P ＜0.001).Conclusions With the aggravation of the disease,the increase of the postprandial GLP-1 level is greatly reduced in the OSAHS patients,and that was related with the decrease of insulin synthesis and secretion.All of the above indicate that GLP-1 may play a role in the development of glucose metabolism disorder caused by OSAHS.
