新医学
新醫學
신의학
New Medicine
2015年
10期
677-681
,共5页
肥胖型%非肥胖型%阻塞性睡眠呼吸暂停低通气综合征%胰岛素抵抗
肥胖型%非肥胖型%阻塞性睡眠呼吸暫停低通氣綜閤徵%胰島素牴抗
비반형%비비반형%조새성수면호흡잠정저통기종합정%이도소저항
Obesity%Non-obesity%Obstructive sleep apnea-hypopnea syndrome%Insulin resistance
目的：探讨男性肥胖型与非肥胖型阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与胰岛素抵抗（IR）之间的关系。方法将因睡眠呼吸问题而就诊的88例男性患者纳入研究，根据多导睡眠图（PSG）、BMI 及睡眠呼吸暂停低通气指数（AHI）将88例分为非肥胖型 OSAHS 组28例（OSAHS 轻度组10例，中重度组18例）、肥胖型 OSAHS 组26例（轻度组10例，中重度组16例）、单纯肥胖组18例和对照组16例。测定各组空腹血糖、空腹胰岛素（FINS）、总胆固醇、甘油三酯、LDL-C、HDL-C，并计算胰岛素抵抗指数（HOMA-IR），比较各组的上述指标，并采用 Pearson 相关与多重线性逐步回归分析 AHI 与各指标间、HOMA-IR 与各指标间的相关性。结果肥胖型 OSAHS 组的空腹血糖、FINS、HOMA-IR、总胆固醇、甘油三酯、LDL-C 水平均高于单纯肥胖组（P 均＜0.05），非肥胖型 OSAHS 组上述指标的水平也均高于对照组（P 均＜0.05）。中重度 OSAHS 组的糖脂异常、IR 程度均较相应的轻度组严重（P 均＜0.05）。OSAHS 患者的 AHI 与 HOMA-IR、总胆固醇、甘油三酯、LDL-C 均呈正相关（P 均＜0.05）；非肥胖型 OSAHS 组中影响 AHI 的因素是 HOMA-IR，影响HOMA-IR 的因素是 AHI。结论在男性患者中，OSAHS 与 IR 相关且独立于肥胖因素，IR 程度随着OSAHS 病情的加重而增加。
目的：探討男性肥胖型與非肥胖型阻塞性睡眠呼吸暫停低通氣綜閤徵（OSAHS）與胰島素牴抗（IR）之間的關繫。方法將因睡眠呼吸問題而就診的88例男性患者納入研究，根據多導睡眠圖（PSG）、BMI 及睡眠呼吸暫停低通氣指數（AHI）將88例分為非肥胖型 OSAHS 組28例（OSAHS 輕度組10例，中重度組18例）、肥胖型 OSAHS 組26例（輕度組10例，中重度組16例）、單純肥胖組18例和對照組16例。測定各組空腹血糖、空腹胰島素（FINS）、總膽固醇、甘油三酯、LDL-C、HDL-C，併計算胰島素牴抗指數（HOMA-IR），比較各組的上述指標，併採用 Pearson 相關與多重線性逐步迴歸分析 AHI 與各指標間、HOMA-IR 與各指標間的相關性。結果肥胖型 OSAHS 組的空腹血糖、FINS、HOMA-IR、總膽固醇、甘油三酯、LDL-C 水平均高于單純肥胖組（P 均＜0.05），非肥胖型 OSAHS 組上述指標的水平也均高于對照組（P 均＜0.05）。中重度 OSAHS 組的糖脂異常、IR 程度均較相應的輕度組嚴重（P 均＜0.05）。OSAHS 患者的 AHI 與 HOMA-IR、總膽固醇、甘油三酯、LDL-C 均呈正相關（P 均＜0.05）；非肥胖型 OSAHS 組中影響 AHI 的因素是 HOMA-IR，影響HOMA-IR 的因素是 AHI。結論在男性患者中，OSAHS 與 IR 相關且獨立于肥胖因素，IR 程度隨著OSAHS 病情的加重而增加。
목적：탐토남성비반형여비비반형조새성수면호흡잠정저통기종합정（OSAHS）여이도소저항（IR）지간적관계。방법장인수면호흡문제이취진적88례남성환자납입연구，근거다도수면도（PSG）、BMI 급수면호흡잠정저통기지수（AHI）장88례분위비비반형 OSAHS 조28례（OSAHS 경도조10례，중중도조18례）、비반형 OSAHS 조26례（경도조10례，중중도조16례）、단순비반조18례화대조조16례。측정각조공복혈당、공복이도소（FINS）、총담고순、감유삼지、LDL-C、HDL-C，병계산이도소저항지수（HOMA-IR），비교각조적상술지표，병채용 Pearson 상관여다중선성축보회귀분석 AHI 여각지표간、HOMA-IR 여각지표간적상관성。결과비반형 OSAHS 조적공복혈당、FINS、HOMA-IR、총담고순、감유삼지、LDL-C 수평균고우단순비반조（P 균＜0.05），비비반형 OSAHS 조상술지표적수평야균고우대조조（P 균＜0.05）。중중도 OSAHS 조적당지이상、IR 정도균교상응적경도조엄중（P 균＜0.05）。OSAHS 환자적 AHI 여 HOMA-IR、총담고순、감유삼지、LDL-C 균정정상관（P 균＜0.05）；비비반형 OSAHS 조중영향 AHI 적인소시 HOMA-IR，영향HOMA-IR 적인소시 AHI。결론재남성환자중，OSAHS 여 IR 상관차독립우비반인소，IR 정도수착OSAHS 병정적가중이증가。
Objective To investigate the relationship between obstructive sleep apnea-hypopnea syn-drome (OSAHS)and insulin resistance (IR)in obese or non-obese male patients.Methods According to polysomnography (PSG),body mass index (BMI)and apnea hypopnea index (AHI),88 patients with sleep-related breathing disorders were divided into four groups:non-obese OSAHS group (n =28;1 0 with mild and 1 8 with moderate and severe OSAHS),obese OSAHS group (n =26;1 0 with mild and 1 6 with moderate and severe OSAHS),obese group (n =1 8)and control group (n =1 6).Fasting glucose,fasting insulin (FINS), serum total cholesterol,triglyceride,low density lipoprotein (LDL-C),high density lipoprotein (HDL-C)were measured and insulin resistance index (HOMA-IR) was calculated and statistically compared among all groups.The correlation between AHI and each index,and between HOMA-IR and each index was analyzed by Pearson correlation and multiple linear regression analyses.Results The levels of fasting glucose,FINS,HO-MA-IR,serum total cholesterol,triglyceride and LDL-C in the obese OSAHS group were significantly higher than those in the obese group (all P <0.05).The same difference was observed between the non-obese OS-AHS and control groups (all P <0.05).Patients with moderate and severe OSAHS had more severe glucose and lipid metabolism abnormality and IR compared with their counterparts with mild OSAHS (both P <0.05).In the OSAHS patients,AHI was positively correlated with HOMA-IR,serum total cholesterol,triglyceride and LDL-C (all P <0.05).In the non-obese OSAHS group,HOMA-IR was the major factor influencing AHI and AHI was also the major influencing factor of HOMA-IR.Conclusions In male OSAHS patients,OSAHS was closely correlated with IR independent of obesity.The severity of IR was deteriorated over the aggravation of OSAHS.
