CAJ | 학술논문

目的：运用双能X射线吸收法（DXA）测定阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者脂肪分布特点，探讨OSAHS与肥胖的关系。方法对49例肥胖者行多导睡眠监测（PSG），根据呼吸暂停低通气指数（AHI）分为OSAHS组及非OSAHS组，分别测量体质量、身高、颈围、腰围、腹围、臀围，计算腰臀比（WHR）、体质量指数(BMI)；检测血脂；运用DXA测量腹部脂肪比、躯干脂肪比及全身脂肪比。结果两组间腰围、臀围、WHR、BMI、全身脂肪比、躯干脂肪比及腹部脂肪比均无差异（P>0.05），而OSAHS组颈围明显增大，差异有统计学意义(P<0.01）。OSAHS患者血总胆固醇（TC）、三酰甘油（TG）增高，差异有统计学意义（P<0.05），高密度脂蛋白胆固醇（HDL-C）显著低于非OSAHS患者（P<0.01）。OSAHS患者夜间平均血氧饱和度（MSaO2）低于非OSAHS组，差异有统计学意义(P<0.05)；而最低血氧饱和度（LSaO2）两组间无差异（P>0.05）。结论 OSAHS患者体内脂肪分布失衡，颈部脂肪堆积明显过多。OSAHS常合并脂代谢紊乱，且病情越重脂代谢紊乱更加明显。
목적：운용쌍능X사선흡수법（DXA）측정조새성수면호흡잠정저통기종합정（OSAHS）환자지방분포특점，탐토OSAHS여비반적관계。방법대49례비반자행다도수면감측（PSG），근거호흡잠정저통기지수（AHI）분위OSAHS조급비OSAHS조，분별측량체질량、신고、경위、요위、복위、둔위，계산요둔비（WHR）、체질량지수(BMI)；검측혈지；운용DXA측량복부지방비、구간지방비급전신지방비。결과량조간요위、둔위、WHR、BMI、전신지방비、구간지방비급복부지방비균무차이（P>0.05），이OSAHS조경위명현증대，차이유통계학의의(P<0.01）。OSAHS환자혈총담고순（TC）、삼선감유（TG）증고，차이유통계학의의（P<0.05），고밀도지단백담고순（HDL-C）현저저우비OSAHS환자（P<0.01）。OSAHS환자야간평균혈양포화도（MSaO2）저우비OSAHS조，차이유통계학의의(P<0.05)；이최저혈양포화도（LSaO2）량조간무차이（P>0.05）。결론 OSAHS환자체내지방분포실형，경부지방퇴적명현과다。OSAHS상합병지대사문란，차병정월중지대사문란경가명현。
Objective We determine the fat distribution characteristics of patients of obstructive sleep apnea hypopnea syndrome (OSAHS) by using dual energy X-ray absorptiometry (DXA) to explore the relationship between OSAHS and obesity. Methods 49 cases of obesity were selected and underwent polysomnography (PSG). According to the apnea-hypopnea index (AHI), they were divided into OSAHS group (AHI≥5) 26 cases and non-OSAHS group (AHI<5) 23 cases. The weight, height, neck circumference, waist circumference, abdominal circumference, hip circumference of each studying object was measured to calculate waist to hip ratio (WHR)and body mass index (BMI);serum lipid level was tested;measurement of abdominal fat, trunk fat ratio and body fat ratio was conducted by DXA. Results There was no signiifcant difference (P>0.05) of waist circumference, hip circumference, waist to hip ratio, body mass index, body fat ratio, ratio of trunk fat and abdominal fat between OSAHS group and non-OSAHS group. The neck circumference of the OSAHS patients was signiifcantly greater than non-OSAHS patients, and the difference was statistically signiifcant (P<0.01). Serum total cholesterol (TC), triglyceride (TG) of OSAHS patients was higher than non-OSAHS patients, and the difference is statistically signiifcant (P<0.05). High density lipoprotein cholesterol (HDL-C) was signiifcantly lower than non-OSAHS patients (P<0.01). There was no signiifcant difference (P>0.05) in Low-density lipoprotein cholesterol (LDL-C) levels between the two groups. The MSaO2 of patients with OSAHS was lower than non-OSAHS group, and the difference was statistically signiifcant (P<0.05);otherwise, there was no signiifcant difference of LSaO2 between the two groups (P>0.05). Conclusion Body fat distribution of OSAHS patients unbalanced. Compared with the non-OSAHS groups with the same degree of obesity, the neck circumference of the former signiifcantly increased. OSAHS was often associated with lipid metabolism disorders, and correlated with AHI. OSAHS patients should be timely clinically diagnosed of abnormal lipid metabolism, to take active preventive measurements.