阻塞性睡眠呼吸暂停综合征糖耐量健康者血糖代谢情况的配对研究

目的评价阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome，OSAS)糖耐量健康者血糖代谢情况。方法选择按照体质量指数(body mass index，BMI)配对的不同程度OSAS糖耐量健康的男性患者共30例，进行睡眠呼吸暂停监测，并测定空腹血糖、空腹胰岛素水平，利用新稳态模型评估法(HOMA2)计算胰岛β细胞功能、胰岛素抵抗指数、胰岛素敏感指数，并作统计学分析。结果BMI配对的呼吸暂停低通气指数(apnea-hypopnoea index，AHI)＜15次/h与AHI＞15次/h的两组患者BMI、年龄、腰臀比、颈围差异均无统计学意义(P＞0.05)；两组患者AHI水平差异有统计学意义(P＜0.05);两组患者夜间最低血氧饱和度差异有统计学意义(P＜0.05)。两组患者空腹血糖水平及HOMA2-胰岛β细胞功能指数差异无统计学意义(P＞0.05)；两组患者空腹胰岛素水平差异有统计学意义(P＜0.05);两组患者HOMA2-胰岛素敏感性指数差异有统计学意义(P＜0.05)；两组患者HOMA2胰岛素抵抗指数差异有统计学意义(P＜0.05)。结论OSAS患者在糖耐量正常阶段存在代偿性高胰岛紊血症，但未出现胰岛β细胞功能缺陷。

Paired study on glucose metabolism in obstructive sleep apnea syndrome patients with normal glucose tolerance

Objective Analysis on glucose metabolism changes in patients with obstructive sleep apnea syndrome (OSAS) and normal glucose tolerance (NGT). Methods Thirty male patients with OSAS and NGT, matched with body mass index (BMI) were selected. The fasting blood glucose, fasting insulin, HOMA2-β cell function, HOMA2-insulin resistance index, HOMA2-insulin sensitivity index were measured and analyzed. Results Compared with control group, the AHI＞15 times/h group observes a significantly higher AHI( P ＜0.05), lower lowest SpO2 ( P ＜0.05), higher fasting insulin ( P ＜0.05), lower HOMA-insulin sensitivity index ( P ＜0.05), and higher HOMA-insulin resistance index ( P ＜0.05). BMI, age, waist to hip ratio,neck, FBG and HOMA2-β cell function were similar in both group( P ＞0.05). Conclusions The data showed that the patients with OSAS and NGT exhibit hyper insulinemia, but not a deficit with pancraetic β cell.