阻塞性睡眠呼吸暂停综合征慢性低氧与非酒精性脂肪肝的相关性

目的 探讨阻塞性睡眠呼吸暂停综合征(OSAHS)患者慢性低氧与非酒精性脂肪肝(NAFLD)的相关性。方法 选择OSAHS患者927例,行多导睡眠监测(PSG),按照最低血氧饱和度指数(LSaO₂)及呼吸暂停低通气指数(AHI)将患者分为单纯鼾症组63例,轻度低氧血症OSAHS组202例,中度低氧血症OSAHS组332例,重度低氧血症OSAHS组330例;生化分析患者空腹血低密度-脂蛋白-胆固醇(LDL-C)、高密度-脂蛋白-胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)水平;所有患者均行肝胆胰脾腹部B超检查。结果 ① 随着缺氧程度加重,OSAHS患者伴NAFLD的检出率升高,重度低氧血症OSAHS伴NAFLD的检出率较单纯鼾症及轻、中度低氧血症的检出率高;② OSAHS伴NAFLD患者与不伴NAFLD患者BMI、TC、TG、HDL-C、LDL-C及中、重度低氧血症水平相比,差异均有统计学意义(P<0.05);③BMI、TC、TG及中、重度低氧血症是OSAHS伴NAFLD的独立危险因素。结论 BMI、TC、TG、轻中重度低氧血症是OSAHS伴NAFLD的独立危险因素,改善患者长期缺氧状态,减轻体质量,控制甘油三酯水平,可能有效预防NAFLD的发生。

Correlation between chronic hypoxia caused by obstructive sleep apnea syndrome and nonalcoholic fatty liver dis-ease

Objective To investigate the correlation between chronic hypoxia caused by obstructive sleep apnea hypopnea syndrome (OSAHS) and nonalcoholic fatty liver disease (NAFLD). Methods A total of 927 OSAHS patients were divided into simple sleep apnea group (n=63), mild hypoxemia OSAHS group (n=202), moderate hypoxemia OSAHS group (n=332), and severe hypoxemia OSAHS group (n=330), according to the lowest oxygen saturation (LSaO₂) and apnea hyponea index (AHI) collected by polysomnography (PSG). The low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), total cholesterol (TC) level of all patients were examined, and abdominal ultrasound was conducted. Results ① As anoxia aggravated, the detection rate of OSAHS with NAFLD increased. In severe hypoxemia, the detection rate of OSAHS with NAFLD was higher than that of simple sleep apnea, mild and moderate hypoxemia. ② There were significant differences in BMI, TC, TG, HDL-C, LDL-C in OSAHS patients with NAFLD and without NAFLD (all P<0.05). ③ The BMI, TC, TG, LDL-C, moderate and severe hypoxemia were independent risk factors for OSAHS with NAFLD. Conclusion OSAHS patients with long-term chronic hypoxia are susceptible to NAFLD. To improve patients' long-term anoxic state, weight loss and control of triglyceride levels may effectively prevent the occurrence of NAFLD.