阻塞性睡眠呼吸暂停与非酒精性脂肪性肝病的关系研究

目的：探讨阻塞性睡眠呼吸暂停（ OSA）与非酒精性脂肪性肝病（ NAFLD）的关系。方法141例进行多导睡眠监测的患者为研究对象，根据监测结果分为阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）组和非OSAHS组，均进行肝脏B超检查。比较两组间一般临床资料和实验室检查结果、呼吸暂停低通气指数（ AHI）指数与NAFLD发病率关系以及最低血氧饱和度（ LSaO2）与肝酶指标的相关性并分析原因。结果诊断为OSAHS者83例，其他58例纳入非OSAHS组。 OSAHS组的性别、年龄、血压、血脂、糖尿病、体质指数（ BMI ）和天冬氨酸氨基转移酶（ AST ），与非OSAHS组比较差异无统计学意义（ P＞0.05），但丙氨酸氨基转移酶（ALT）、稳态模型胰岛素抵抗（HOMA-IR）指数和NAFLD发病率较非OSAHS组显著增高（P＜0.01）。 AHI指数增加与NAFLD发病率相关。在OSAHS组中，LSaO2与ALT呈负相关，而与AST无相关性。结论 OSA患者易于发生NAFLD，可能与胰岛素抵抗和夜间间歇性低氧有关。

Research between obstructive sleep apnea and nonalcoholic fatty liver disease

Objective To investigate the relationship between obstructive sleep apnea and nonalcoholic fatty liver disease . Methods 141 patients who underwent polysomnography and liver ultrasonography were enrolled .The main clinical features were com-pared between patients with and without OSAHS .The relationship between AHI and incidence of NAFLD was evaluated ,and Pearson’ s correlation coefficient was calculated between serum aminotransferase values and LSaO 2 .Results 83 cases were diagnosed as OSAHS . There were no significant differences between two groups for gender distribution ,age,hypertension,hyperlipidemia,diabetes mellitus, BMI or AST（P〉0.05）.The incidence of NAFLD,ALT and HOMA-IR were significantly higher in OSAHS group compared with non-OSAHS group（P〈0.01）.Pearson’s correlation coefficient demonstrated a significant correction between ALT and LSaO 2 in OSAHS patients.Conclusion Patients with OSA are more prone to NAFLD ,which may be associated with insulin resistance and nocturnal in-termittent hypoxia .