阻塞性睡眠呼吸暂停综合征患者胰岛素抵抗与血清脂联素的关系

目的研究阻塞性睡眠呼吸暂停综合症（OSAS）患者胰岛素抵抗同血清脂连素、抵抗素水平的关系。方法采用两两匹配的病例对照研究，选择体重、年龄相当的老年OSAS患者50例作为病例组，另外选取35例单纯打鼾组作为对照，使用多导睡眠仪进行监测，并使用放射免疫分析法、酶联免疫法测定研究对象的血清脂连素、抵抗素水平。采用稳态模型法（HOMA）计算IR指数。结果病例组的血清脂连素水平低于对照组，而甘油三酯水平，空腹胰岛素（FINS）、HoMA-IR、抵抗素水平均高于对照组。经Logistic多元回归分析显示血糖指数、体重指数、呼吸暂停低通气指数、脂连素、抵抗素均是OSAS患者发生胰岛素抵抗的独立危险因素。结论OSAS患者病情进一步加重与脂连素、抵抗素有关，而发展为胰岛素抵抗可能同空腹血糖、空腹胰岛素、体重指数、呼吸暂停通气指数均有关系。通过控制上述指标可能降低OSAS患者并发IR的风险。

Relationship between serum adiponectin and resistin in old patients with obstnlctive sleep apnea syndrome with insulinresistance

Objective To study the changes of Serllm adiponectin and resistin levels in old patients with OSAS and the relationship of adiponeetin and resistin with insulin resistance（IR）. Methods Using two matched case-control study, choose the weight, age, quite in elderly patients with OSAS 50 cases as a group, in addition to choose simple snoring group 35 cases as a contrast, using multiple guide apparatus to monitor the sleep, and use the radiation immunoassay, enzyme-linked immune method to determine the object of study of serum lipid even element, resistin level. By using the steady state model method（HOMA） index calculation of IR. Results Cases of serum lipid levels lower than the control group, and triglyceride levels, fasting insulin（FINS）, HOMA IR, resistin levels were higher than the control group. After Logistic multivariate regression analysis showed that glycemic index, body mass index, apnea hypoventilation index, grease even element, resistin are independent risk factors of insulin resistance in patients with OSAS. Conclusion OSAS patients further related to fat even element, resistin, and for the development of insulin resistance may be with fasting Mood glucose, fasting insulin, body mass index, apnea ventilation index have relations. By controllin the above indicators may reduce the risk of OSAS patients complicated with IR.