阻塞性睡眠呼吸暂停综合征对血脂及糖代谢的影响

目的：探讨阻塞性睡眠呼吸暂述综合征（OSAS）对血脂及糖代谢的影响。方法：选择OSAS患者60例（分为轻、中、重度3组）和正常对照组20名行多导睡眠图（PSG）检查和血糖、胰岛素、C肽、糖化血红蛋白A1c(GHbA1c)、胰岛素敏感指数（ISI）、血清总胆固醇、甘油三酯和HDL－C测定。结果：OSAS组空腹时血糖、HGbA1c、胰岛素、C肽、总胆固醇、甘油三酯水平明显高于正常组，且OSAS病情越严重，以上指标水平越高。重度OSAS组HDL－C较正常组明显降低。各组体重指数、空腹血糖、GHbA1c、胰岛素、C肽、甘油三酯与睡眠呼吸暂停低通气指数（AHI）、经皮血氧饱和度（SpO2)降低大于0．04的总次数、SpO2低于0．90的时间呈正相关，而与入睡前SpO2的基础值、睡眠中SpO2最低值、SpO2平均值呈负相关。结论：AHI、呼吸暂停持续时间及SpO2降低的程度与OSAS患者血糖增高、糖耐量降低、血脂异常（特别是高甘油三酯血症）有关。

The influence of obstructive sleep apnea syndrome on lipid and glucose metabolism

Objective: To study the influence of obstructive sleep apnea syndrome (OSAS) on lipid and glucose metabolism. Methods: Sixty OSAS patients and 20 normal volunteers were evalucted by polysomnography during sleep. Serum glucose (SG), insulin, C peptide, HbA1C, insulin sensitive index (ISI), total cholesterol (TC), triglyceride (TG) and high density lipoprotein (HDL C) were measured. Results: SG, insulin, C peptide, HbA1C, TC and TG were significantly higher in OSAS group than that of controls. There were also significantly differences in these parameters among mild, moderate and severe OSAS. HDL C was significantly lower in severe OSAS than in control. SG, insulin, C peptide, HbA1C and TG were positive correlated to apnea hypopnea index (AHI), the incidence of cutaneous of oxygen from skin (SpO2) dip greater than 0.04 and the duration of SpO2 less than 0.90 and were negatively correlated to the minimum value of SpO2 and the mean of SpO2 during sleep. Conclusion: AHI, apnea duration and extent of SpO2 decrease are important factors affecting lipid and glucose metabolism in OSAS.