阻塞性睡眠呼吸暂停低通气综合征患者血清脂联素水平的研究

目的 探讨血清脂联素在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者体内的变化。方法 选择伴有肥胖的OSAHS患者71例(肥胖OSAHS组)、不伴肥胖的OSAHS患者21例(非肥胖OSAHS组)、单纯性肥胖者26例(单纯性肥胖组)和健康成人22例(正常对照组)。其中肥胖OSAHS组和单纯性肥胖组的体重指数(BMI)均大于25,两组间BMI差异无显著性。肥胖OSAHS组又进一步分为轻度(26例)、中度(22例)和重度(23例)。均接受多导睡眠仪监测和放射免疫法测定血清脂联素水平。结果 正常对照组血清脂联素水平(8.9±0.6)mg/L]显著高于单纯性肥胖组(7.1±1.3)mg/L](P<0.05)、非肥胖OSAHS组(5.4±0.6)mg/L,P<0.01]和肥胖OSAHS组(5.0±1.0)mg/L,P<01]。与单纯性肥胖组的血清脂联素水平相比,无论肥胖OSAHS组或非肥胖OSAHS组均显著降低,差异有显著性(P<0.05)。肥胖OSAHS组与非肥胖OSAHS组的血清脂联素水平相比,差异无显著性(P>0.05)。肥胖OSAHS组与单纯性肥胖组的分析显示:血清脂联素水平与呼吸暂停低通气指数(AHI)(r=-0.78,P<0.01)、BMI(r=-0.21,P<0.05)、腰围(r=-O.36,P<0.01)和颈围呈负相关(r=-0.42,P<0.01),与最低脉搏血氧饱和度呈正相关(r=0.48,P<0.01)。结论 OSAHS患者中血清脂联素水平较正常对照和单纯肥胖者更低,除了腰围和颈围的因素

Serum adiponectin levels in patients with obstructive sleep apnea-hypopnea syndrome

OBJECTIVE: To explore the changes of serum adiponectin levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: Polysomnography was performed in 71 obese OSAHS patients (obese OSAHS group), 21 OSAHS patients without obesity (non-obese OSAHS group), 26 obese controls (obese group) and 22 normal healthy adults (control group). In both the obese OSAHS group and obese group, the body mass index (BMI) was higher than 25 and there was no significant difference in BMI. Serum adiponectin levels were measured by radioimmunoassay. RESULTS: The serum adiponectin level in the control group (8.9 +/- 0.6) mg/L] was significantly higher than those in the obese group (7.1 +/- 1.3) mg/L, P < 0.05], the non-obese OSAHS group (5.4 +/- 0.6) mg/L, P < 0.01] and the obese OSAHS group (5.0 +/- 1.0) mg/L, P < 0.01] respectively. The serum adiponectin level was significantly lower in both the obese OSAHS group and the non-obese OSAHS group (all P < 0.05). The serum adiponectin levels between the obese OSAHS group and the non-obese OSAHS group showed no statistical difference (P > 0.05). In the obese OSAHS patients and the obese patients serum adiponectin levels were negatively correlated with AHI (r = -0.78, P < 0.01), BMI (r = -0.21, P < 0.05), waist circumference (r = -0.36, P < 0.01), and neck circumference (r = -0.42, P < 0.01), but positively correlated with minimal pulse oxygen saturation (r = 0.48, P < 0.01). CONCLUSIONS: Serum adiponectin levels were significantly lower in OSAHS patients than in the normal control and the obese patients. In addition to increased waist and neck circumferences, OSAHS may contribute to the decreased serum adiponectin level.