阻塞性睡眠呼吸暂停对糖尿病发生的影响

目的 :探讨阻塞性睡眠呼吸暂停综合征 (OSAS)对Ⅱ型糖尿病发生的影响。方法 :选择OSAS患者 6 0例和正常对照组 2 0例行多导睡眠图 (PSG)检查和空腹血糖 (FPG)、餐后 2h血糖 (2HPG)、空腹胰岛素 (FINS)、空腹C -肽 (FCP)、糖化血红蛋白A1c(GHbA1c)测定。结果 :OSAS组的FPG、2HPG、GHbA1c、FINS、FCP水平均明显高于正常组 ,且OSAS病情越重 ,轻、中、重度组间差别也越显著。各组BMI、FPG、2HPG、GHbA1c、FINS、FCP及糖尿病发生率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 .0 4的总次数、SpO2 低于 0 .90的时间呈显著正相关 ,而与睡眠中SpO2 最低值和平均值呈显著负相关。结论 :AHI、呼吸暂停持续时间及SpO2 降低的程度是导致OSAS患者糖耐量减低和Ⅱ型糖尿病发生的重要的因素

CONTRIBUTION OF OBSTRUCTIVE SLEEP APNEA SYNDROME TO THE DEVELOPMENT OF DIABETES MELLITUS

Objective:To study the influence of obstructive sleep apnea syndrome (OSAS) to the development of type 2 diabetes mellitus.Methods:Sixty OSAS patients and 20 normal volunteers were measured by polysomnography during sleep and were the fasting plasma glucose (FPG), plasma glucose 2 hours after meals (2HPG), fasting insulin (FINS), fasting C-peptide (FCP),HbA 1c and insulin sensitive index (ISI) in these people were determined.Results:FPG,2HPG,FINS,FCP and HbA 1c were significant higher in OSAS group than those in the controls.There were also significant differences in these profiles among the mild, moderate and severe group of OSAS.BMI, FPG, 2HPG, FINS, FCP, HbA 1c and incidence of type 2diabetes mellitus were positively correlated to apnea hypopnea index (AHI),the occurrence of saturation of oxygen from skin (SpO 2) decrease to more than 0.04, the duration of lowered SpO 2 to less those 0.09.These profiles were negatively correlated to the minimum value of SpO 2 and the mean of SpO 2 in sleep.Conclusions:AHI, apnea duration and extent of SpO 2 decrease are important agents to the abnormal glucose metabolism and development of type 2 diabetes mellitus in OSAS.