中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
42期
3420-3423
,共4页
齐家超%林其昌%林新%陈晓
齊傢超%林其昌%林新%陳曉
제가초%림기창%림신%진효
睡眠呼吸暂停综合征%内脏脂肪指数%转氨酶类%非酒精性脂肪肝
睡眠呼吸暫停綜閤徵%內髒脂肪指數%轉氨酶類%非酒精性脂肪肝
수면호흡잠정종합정%내장지방지수%전안매류%비주정성지방간
Sleep apnea syndromes%Visceral adiposity index%Transaminases%Fatty liver,nonalcoholic
目的 探讨睡眠呼吸暂停(SA)患者内脏脂肪指数与转氨酶水平及非酒精性脂肪肝发生的关系.方法 纳入2011年1月至2014年12月因反复打鼾或睡眠呼吸障碍至福建省睡眠疾病诊治中心就诊的患者.患者均行多导睡眠图(PSG)监测及腹部超声检查,根据呼吸暂停低通气指数(AHI)分为非SA组及轻、中、重度SA组(AHI分别为:＜5、5～＜15、15～＜30、≥30次/h).比较组间PSG相关参数、转氨酶、内脏脂肪指数等差异.运用Spearman相关分析探讨内脏脂肪指数与PSG相关参数及转氨酶的相关性.以受试者工作特征(ROC)曲线及logistic回归分析内脏脂肪指数预测非酒精性脂肪肝发生的最佳切点及风险.结果 共分析152例患者资料,其中男110例,女42例,年龄(51.1±11.3)岁.其中,非SA组20例,轻、中、重度SA组分别有31、39、62例.152例患者中非酒精性脂肪肝患者92例.不同SA组间性别、年龄、碱性磷酸酶差异均无统计学意义(均P＞0.05),而体质指数、腰围、AHI、最低血氧饱和度、氧减指数(ODI)、内脏脂肪指数、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、非酒精性脂肪肝患病率差异均有统计学意义(均P＜0.05).内脏脂肪指数与AHI(β=0.222,P=0.006)、ODI(β =0.216,P=0.008)、ALT(β=0.237,P=0.003)、GGT(β=0.238,P=0.003)呈正相关.ROC曲线提示,在总人群中,内脏脂肪指数预测非酒精性脂肪肝发生的最佳切点为1.59.高内脏脂肪指数组发生非酒精性脂肪肝风险增加至4.550倍(OR=4.550,P＜0.001).结论 内脏脂肪指数与SA患者转氨酶水平及非酒精性脂肪肝的发生密切相关.
目的 探討睡眠呼吸暫停(SA)患者內髒脂肪指數與轉氨酶水平及非酒精性脂肪肝髮生的關繫.方法 納入2011年1月至2014年12月因反複打鼾或睡眠呼吸障礙至福建省睡眠疾病診治中心就診的患者.患者均行多導睡眠圖(PSG)鑑測及腹部超聲檢查,根據呼吸暫停低通氣指數(AHI)分為非SA組及輕、中、重度SA組(AHI分彆為:＜5、5～＜15、15～＜30、≥30次/h).比較組間PSG相關參數、轉氨酶、內髒脂肪指數等差異.運用Spearman相關分析探討內髒脂肪指數與PSG相關參數及轉氨酶的相關性.以受試者工作特徵(ROC)麯線及logistic迴歸分析內髒脂肪指數預測非酒精性脂肪肝髮生的最佳切點及風險.結果 共分析152例患者資料,其中男110例,女42例,年齡(51.1±11.3)歲.其中,非SA組20例,輕、中、重度SA組分彆有31、39、62例.152例患者中非酒精性脂肪肝患者92例.不同SA組間性彆、年齡、堿性燐痠酶差異均無統計學意義(均P＞0.05),而體質指數、腰圍、AHI、最低血氧飽和度、氧減指數(ODI)、內髒脂肪指數、丙氨痠轉氨酶(ALT)、天鼕氨痠轉氨酶(AST)、穀氨酰轉肽酶(GGT)、非酒精性脂肪肝患病率差異均有統計學意義(均P＜0.05).內髒脂肪指數與AHI(β=0.222,P=0.006)、ODI(β =0.216,P=0.008)、ALT(β=0.237,P=0.003)、GGT(β=0.238,P=0.003)呈正相關.ROC麯線提示,在總人群中,內髒脂肪指數預測非酒精性脂肪肝髮生的最佳切點為1.59.高內髒脂肪指數組髮生非酒精性脂肪肝風險增加至4.550倍(OR=4.550,P＜0.001).結論 內髒脂肪指數與SA患者轉氨酶水平及非酒精性脂肪肝的髮生密切相關.
목적 탐토수면호흡잠정(SA)환자내장지방지수여전안매수평급비주정성지방간발생적관계.방법 납입2011년1월지2014년12월인반복타한혹수면호흡장애지복건성수면질병진치중심취진적환자.환자균행다도수면도(PSG)감측급복부초성검사,근거호흡잠정저통기지수(AHI)분위비SA조급경、중、중도SA조(AHI분별위:＜5、5～＜15、15～＜30、≥30차/h).비교조간PSG상관삼수、전안매、내장지방지수등차이.운용Spearman상관분석탐토내장지방지수여PSG상관삼수급전안매적상관성.이수시자공작특정(ROC)곡선급logistic회귀분석내장지방지수예측비주정성지방간발생적최가절점급풍험.결과 공분석152례환자자료,기중남110례,녀42례,년령(51.1±11.3)세.기중,비SA조20례,경、중、중도SA조분별유31、39、62례.152례환자중비주정성지방간환자92례.불동SA조간성별、년령、감성린산매차이균무통계학의의(균P＞0.05),이체질지수、요위、AHI、최저혈양포화도、양감지수(ODI)、내장지방지수、병안산전안매(ALT)、천동안산전안매(AST)、곡안선전태매(GGT)、비주정성지방간환병솔차이균유통계학의의(균P＜0.05).내장지방지수여AHI(β=0.222,P=0.006)、ODI(β =0.216,P=0.008)、ALT(β=0.237,P=0.003)、GGT(β=0.238,P=0.003)정정상관.ROC곡선제시,재총인군중,내장지방지수예측비주정성지방간발생적최가절점위1.59.고내장지방지수조발생비주정성지방간풍험증가지4.550배(OR=4.550,P＜0.001).결론 내장지방지수여SA환자전안매수평급비주정성지방간적발생밀절상관.
Objective To evaluate the relationship of visceral adiposity index (VAI) with serum aminotransferase levels and incidence of nonalcoholic fatty liver disease (NAFLD) in patients with sleep apnea (SA).Methods Between January 2011 and December 2014,participants who were referred from Fujian Provincial Sleep-disordered Breathing (SDB) Clinic Center with repeated snoring or a clinical suspicion of SDB were recruited.All individuals underwent polysomnography (PSG) testing and an abdominal ultrasonography scan during this period.They were classified into four groups by apnea-hypopnea index (AHI),non-SA group,mild,moderate and severe group (AHI ＜5/h,5-＜ 15/h,15-＜30/h,≥ 30/h,respectively).The differences in SA-related parameters,serum aminotransferase and VAI were tested,and the correlations of VAI with indices of PSG and serum aminotransferase were analyzed using Spearman coefficient.Receiver operating characteristic (ROC) curve was conducted to obtain a cut-off value of VAI for predicting NAFLD.Afterwards,logistic regression was performed to analyze VAI's predictive ability regarding incidence of NAFLD in SDB patients.Results A total of 152 participants including 110 males and 42 females were analyzed,with mean age (51.1 ±11.3) years.There were 20 subjects in non-SA group,31 in mild,39 in moderate and 62 in severe group,with 92 NAFLD patients and 60 controls.No differences in sex,age,alkaline phosphatase were observed among groups according to AHI.However,body mass index,waist circumference,AHI,lowest oxygen saturation,oxygen desaturation index (ODI),VAI,alanine aminotransferase (ALT),aspartate aminotransferase,gamma glutamyltransferase (GGT) and incidence of NAFLD were significantly different among groups.Significant positive relations were observed between VAI and AHI (3 =0.222,P =0.006),ODI (β =0.216,P =0.008),ALT (β =0.237,P =0.003),GGT (β =0.238,P =0.003).As shown in ROC curve,the cut-off point of VAI for predicting NAFLD was 1.59 in all individuals.SDB patients with VAI ≥ 1.59 tended to have significantly greater risk in incidence of NAFLD (OR =4.550,P ＜ 0.001).Conclusion VAI was closely associated with increased serum aminotransferase levels and incidence of NAFLD.
