阻塞性睡眠呼吸暂停低通气综合征与糖代谢紊乱

阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是一常见病，其心脑血管疾病的发病率及病死率也明显增高，但其机制并不十分清楚。阻塞性睡眠呼吸事件可导致许多急性的病理生理改变如间断低氧、严重睡眠片段、急性血压升高、交感神经系统激活、胸内压改变及心输出量降低等，反复而长期的上述改变最终可导致高血压及心脑血管疾病，而睡眠呼吸暂停与糖代谢异常之间的独立关系也可能代表了另一条导致心血管疾病的途径。本文对OSAHS与糖代谢异常之间的关系、糖代谢异常的可能中间机制及治疗OSAHS本身对糖代谢异常的影响等进行了深入阐述。

Obstructive sleep apnea hypopnea syndrome and disorders of glucose metabolism

Obstructive sleep apnea hypopnea syndrome (OSAHS is a prevalent disorder among middle-aged obese men,and is known to be associated with increased mobility and mortality of cardiovascular disease,but the role of OSAHS in cardiovascular disease is uncertain.The recurrent obstructive respiratory event during sleep can cause many acute pathophysiology changes such as intermittent hypoxemia,fragmented sleep,acute increase of blood pressure,activating of sympathetic nerve,change of intrathoracic pressure and decrease of cardiac output,which can finally cause hypertension and cardiovascular diseases.But the independent association between sleep apnea and glucose metabolism also presents another way that cause cardiovascular disease.This article is to review the association between OSAHS and insulin resistance,the intermediated mechanisms of altered glucose metabolism in sleep apnea and the effects of sleep apnea treatment on glucose metabolism.