阻塞性睡眠呼吸暂停综合征对2型糖尿病患者夜间血糖漂移的影响

目的 观察阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea hypopnea syndrome,OSAHS)对2型糖尿病患者血糖水平及夜间血糖漂移的影响。 方法 选择2型糖尿病(Type 2 diabetes mellitus,T2DM)伴OSAHS患者31例及单纯T2DM患者18例,所有患者应用动态血糖监测系统(CGMS)连续进行动态血糖监测3 d,比较2组患者夜间血糖、空腹血糖、24 h血糖、夜间MAGE(Mean amplitude of plasma glucose excursion)、白天MAGE、24 h MAGE以及糖化血红蛋白(hemoglycoglobulin, GhBA1c)。 结果 单纯T2DM组及T2DM伴OSAHS组性别、年龄、病程差异无统计学意义,而体重指数、腰围、颈围差异有统计学意义(P0.05),体重指数、腰围、颈围校正后,T2DM伴OSAHS组患者夜间MAGE、24 h MAGE显著高于单纯T2DM组(P0.01),两组患者夜间血糖、空腹血糖、24 h血糖、白天MAGE及GhBA1c差异也有统计学意义(P0.05)。 结论 OSAHS引起T2DM夜间血糖、夜间MAGE增高,从而影响全天血糖及全天MAGE。

Impact of obstructive sleep apnea hypopnea upon nocturnal glucose drifting in type 2 diabetes patients

Objective To observe the impact of obstructive sleep apnea hypopnea syndrome(OSAHS) upon glucose control and nocturnal glucose drifting in type 2diabetes patients.Methods Thirty one type 2 diabetes patients with OSAHS(group 1) and 18 type 2 diabetes patients without OSAHS(group 2) in our hospital were selected to conduct continuous glucose monitoring for 3 days and compare the nocturnal plasma glucose,fasting plasma glucose,24 h plasma glucose,nocturnal mean amplitude of plasma glucose excursion(MAGE),day time MAGE,24 h MAGE and GhBA1c between two groups.Results There was no significant differences in sex,age,duration of diabetes between 2 groups,but there was significance differences in body mass index,waist circumference and neck circumference(P<0.05).Nocturnal MAGE and 24 h MAGE were significantly higher in group 1 than in group 2 after adjust of body mass index,waist circumference and neck circumference(P<0.01) There were statistical differences on nocturnal plasma glucose,fasting plasma glucose,24 h plasma glucose,24 h MAGE and GhBA1c(P<0.05) between 2 groups.Conclusion OSAHS may have an impact not only upon nocturnal plasma glucose,nocturnal MAGE,but also upon 24 h blood glucose and glucose drifting.