阻塞性睡眠呼吸暂停低通气综合征与非酒精性脂肪性肝病的相关性研究

目的 探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与非酒精性脂肪性肝病（NAFLD）的相关性.方法 2005年至2009年,在新疆维吾尔自治区人民医院高血压科完成睡眠呼吸监测1 693例,诊断为OSAHS的1 324例,非OSAHS 的369例,经腹部B超诊断为脂肪肝841例,非脂肪肝852例.根据睡眠呼吸暂停及呼吸紊乱指数（AHI）分为4组（正常组,轻度、中度、重度OSAHS组）,根据脂肪肝与非脂肪肝两组患者年龄、性别、腹围、BMI、AHI、最低血氧饱和度、TC、TG、HDL-C、LDL-C、空腹血糖等指标,分析各因素与脂肪肝的相关性.结果 OSAHS患者与非OSAHS患者的性别、年龄、脂肪肝患病率、TC（4.5±1.0） mmol/L与（4.4±0.9） mmol/L]、TG（2.4±2.0） mmol/L与（2.1±1.8） mmol/L]、LDL-C（2.69±0.76） mmol/L与（2.60±0.75） mmol/L]、空腹血糖（5.3±1.4） mmol/L与（5.0±1.1） mmol/L]、ALT（33±23） U/L与（30±21） U/L]、乳酸脱氢酶（169±37） U/L与（163±36） U/L]、α-羟丁酸脱氢酶 （134±29） U/L与（130±29）U/L]比较差异均有统计学意义（P＜0.05）.OSAHS患者中脂肪肝占52.3%,非OSAHS患者中占40.9%;重度OSAHS组中脂肪肝检出率（59.1%）明显高于其他组（P＜0.05）.多元logistic回归分析提示,AHI、BMI、空腹血糖是脂肪肝发病的风险因素.结论 OSAHS与非酒精性脂肪性肝病有相关性,重度OSAHS组中脂肪肝患者检出率高.

Associations between nonalcoholic fatty liver disease and obstructive sleep apnea syndrome

Objective To explore the relativity of nonalcoholic fatty liver disease （NAFLD）and obstructive sleep apnea syndrome （OSAHS）. Methods A total of 1 693 patients were randomly recruited from 2005 to 2009 from in-hospital hypertensive patients checked by polysomnography （PSG） at our Sleep Center. Among them, 841 patients were diagnosed with fatty liver and another 852 non-fatty liver by type B ultrasound. The subjects underwent PSG and were divided into 4 groups according to apnea-hypopnea index （AHI）. The indices of NAFLD and non-NAFLD groups, including age, gender, abdominal girth, body mass index （BMI）, apnea hypopnea index （AHI）, lowest arterial oxygen saturation, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and fasting blood-glucose （ FBG）, were analyzed. Results Gender, age, TC （4. 5 ± 1.0 ） vs. （4.4±0.9） mmoL/L], TG（2.4 ±2.0） vs. （2. 1 ±1.8） mmol/L], LDL-C （2.69±0.76） vs. （2.60± 0. 75 ） mmol/Ll, FBG （5.3 ± 1.4） vs. （5.0 ± 1.1 ） mmol/L], ALT （33 ± 23 ） U/L vs. （30 ± 21 ） U/L] and LDH （ 169 ±37） vs. （ 163 ± 36） U/El α-HDBH （ 134 ± 29） vs. （ 130 ± 29） U/L] had significant differences between OSAHS and non-OSAHS groups （P 〈 0. 05 ）. The proportion of fatty liver was 52. 3% in OSAHS group versus 40. 9% in non-OSAHS group. Patients in severe OSAHS group had a higher detection rate of NAFLD than the other three groups （ P 〈 0. 05 ）. Multivariate logistic regression suggested that AHI, BMI, FBG, TC and TG/HDL-C were risk factors of fatty liver（ P 〈 0. 05 ）while age was a protective factor （P 〈 0. 05 ）. Conclusion There are correlations between OSAHS and NAFLD. And patients in severe OSAHS group have a higher detection rate of NAFLD.