胰岛素抵抗、瘦素和阻塞性睡眠呼吸暂停低通气综合征的关系

目的探讨胰岛素抵抗（IR）、瘦素和阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的关系。方法检测并分析对照组、肥胖的轻度OSAHS组、肥胖的中重度OSAHS组、非肥胖的轻度OSAHS组和非肥胖的中重度OSAHS组的体重指数、颈围、腰围、HOMA2-IR、血清瘦素水平和血脂系列。结果（1）肥胖的轻度、中重度OSAHS组和非肥胖的中重度OSAHS组的HOMA2-IR、瘦素高于对照组（P〈0．01）。肥胖和非肥胖的中重度OSAHS组的HOMA2-IR、瘦素均高于相应的轻度OSAHS组（P〈0．01）。（2）瘦素与HOMA2-IR、AHI、BMI、颈围、腰围、TG呈正相关（P〈0．05—0．001），与HDL—C呈负相关（P〈0．05）。HOMA2-IR与瘦素、BMI、颈围、腰围、AHI呈正相关（P〈0．001），与HDL—C呈负相关（P〈0．05）。（3）多元逐步回归分析，得出影响瘦素的因素依次是AHI、BMI、CH；影响HOMA2-IR的因素依次是瘦素、BMI和AHI。结论OSAHS是影响IR、血清瘦素水平的独立危险因素，高瘦素水平是影响IR的重要危险因素。

Correlation of insulin resistance and leptinin with obstructive sleepy respiratory stop syndrome

Objective To explore the correlation of insulin resistance （IR） and leptin with obstructive sleep apnea - hypopnea syndrome（OSAHS）. Methods The parameters of HOMA2 - IR, BMI, neck collar（NC） , waist circumference （WC）, serum leptin and lipid profiles of 20 normal adults （control group）, 15 mild OSAHS patients with obesity, 22 moderate -severe OSAHS patients with obesity, 13 mild OSAHS patients without obesity and 20 moderate -severe OSAHS patients without obesity were determined and analyzed. Results （ 1 ） the levels of HOMA2 - IR and serum leptin in mild, moderate - severe OSAHS patients with obesity and moderate - severe OSAHS patients without obesity were significantly higher than those of the controls （P 〈 0.01 ）. The levels of HOMA2 - IR and serum leptin in moderate - severe OSAHS patients with obesity or without obesity were significantly higher than those of mild OSAHS patients （P 〈 0.01 ）. （2）The level of serum leptin was positively correlated with the levels of HOMA2 -IR, AHI, BMI, NC, WC ,TG and inversely correlated with HDL - C （P 〈 0.05 - 0. 001 ）. The level of HOMA2- IR was positively correlated with the levels of leptin, BMI, NC, WC , AHI and inversely correlated with the level of HDL - C （ P 〈 0.05 - 0. 001 ）. （ 3 ） The results of multivariate stepwise regression analysis indicated that leptin was related to AHI, BMI and CH and HOMA2 - IR was assoicated with the levels of leptin, BMI and AHI. Conclusion OSAHS was an independent risk factor of IR and high serum leptin level. High serum leptin level was an important risk factor of IR.