阻塞性睡眠呼吸暂停低通气与代谢综合征的相关性研究

目的探索阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与代谢综合征(MS)的相关关系。方法86例男性OSAHS患者(OSAHS组)按照呼吸暂停低通气指数(AHI)分为轻、中及重度OSAHS亚组。241例(AHI<5)年龄和体重相匹配的健康男性作为正常对照组。其中25例OSAHS和MS并存患者进行CPAP治疗(治疗组)。比较OSAHS组与对照组,以及治疗组治疗前后MS的患病率,外周循环代谢参数的差异和相关性。分析治疗组CPAP治疗前后胰岛素抵抗(IR)的改变。结果舒张压、平均压、臀围、腰围、腰臀比、HDL-C在OSAHS组和对照组差异有显著性;OSAHS组及各亚组MS患病率均显著高于对照组,且MS患病率随OSAHS程度加重而显著增高;多因素逐步Logistic回归分析显示OSAHS为MS的危险因素,其中重度OSAHS患者比正常对照组患病危险增加43倍多;多因素逐步Logistic回归分析显示OSAHS是MS的独立危险因素。CPAP治疗后,治疗组患者腰围、收缩压、舒张压、FBG均有显著降低,IR改善,MS患病比例下降。结论OSAHS与MS密切相关,是MS的独立危险因素之一;CPAP治疗能改善胰岛素抵抗,降低MS患病率。

Analysis on correlation between obstructive sleep apnea hypopnea and metabolic syndromes

[Objective] To investigate the association between obstructive sleep apnea hypopnea syndrome (OSAHS) and metabolic syndrome (MS). [Methods] 86 male patients with OSAHS were recruited as OSAHS group, which was further divided into mild, moderate and severe OSAHS subgroups. 241 normal male adults with AHI<5 and their age and body weight index (BMI) matched were recruited as control group. The incidence of MS was compared between normal and OSAHS subjects. All subjects investigated were tested for their metabolic parameters of peripheral circulation. In OSAHS subgroup CPAP treatment was performed in 25 subjects (treatment group). Comparison was made for correlation and difference of all parameters between OSAHS and control groups as well as before and after CPAP treatment in treatment group. [Results] There was a significance difference between two groups in the following parameters: diastolic and mean arterial blood pressure, circumference of waist(WC) and hip(HC), waist-to hip ratio(WHR) and high density lipoprotein cholesterone(HDL-C). Compared with control group, the incidences of MS were not only significantly higher in OSAHS group as well as in its subgroups, but also became more remarkably high as OSAHS became more severe. Multiple factor stepwise regression analysis showed that OSAHS was the independent risk factor of MS. After CPAP treatment, there was a significant decrease in WC, systolic and diastolic blood pressure, FBG, IR and incidence of MS. [Conclusion] OSAHS is closely associated with MS. OSAHS is one of the independent risk factors. CPAP treatment can improve IR and reduce the incidence of MS.