老年阻塞性睡眠呼吸暂停综合征与高血压及胰岛素抵抗的相关性研究

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)与高血压及胰岛素抵抗(IR)的关系。方法随机选择符合OSAS患者48例作为OSAS组,并分为高血压组(28例)和正常血压组(20例)2个亚组,同期选择无OSAS的高血压患者30例作为单纯高血压组,健康体检者26例作为正常对照组,均进行整夜睡眠呼吸监测(7 h),并记录睡眠呼吸暂停低通气指数(AHI)等;空腹血糖(FPG)及空腹胰岛素(FINS)测定,对患者进行24 h的动态血压监测并进行相关分析。结果与单纯高血压组比较,高血压组患者非杓形血压比例和脉压均明显升高,差异有统计学意义(P0.05,P0.01)。OSAS组患者的FPG、FINS水平及胰岛素抵抗指数(HOMA-IR)均明显高于正常对照组,差异有统计学意义(P0.05);OSAS患者的AHI与FINS和HOMA-IR均呈正相关。结论 OSAS与IR存在独立的相关性,可能通过IR导致并进一步加重心血管疾病的发生和发展。

The relationship of obstructive sleep apnea-hypopnea syndrome with hypertension and insulin resistance

Objective To explore the relationship of obstructive sleep apnea-hypopnea syndrome (OSAS) with hypertension and insulin resistance.Methods Forty-eight patients with OSAS (OSAS group) and 30 hypertension patients without OSAS were selected as pure hypertension group,and 26 normal subjects served as control group.The OSAS group was divided into two groups according to their blood pressure,namely hypertensive group and normotensive group. Polysomnography and ABPM were examined during sleep,and fasting plasma glucose and fasting plasma insulin(FINS) were detected in all groups.Results Compared with pure hypertension group,the proportion of non-liper-type hypertension and pulse pressure significantly increased in hypertensive group.Fasting plasma glucose,FINS and HOMA-IR were significantly higher in OSAS group than in control group (P< 0.05) regardless of their blood pressure.HOMA-IR and FINS were significantly positively correlated to apnea hypopnea index.Moderate and severe OSAS affects the rhythm of blood pressure variability as well as does the pulse pressure.Conclusion OSAS may be independently associated with insulin resistance.