中年男性阻塞性睡眠呼吸暂停低通气综合征骨密度检测状况

目的 测定中年男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的骨密度值(BMD),了解其骨密度的改变情况,探讨OSAHS的严重程度与骨密度变化的相关性及临床意义。方法 选择OSAHS患者48例作为OSAHS组,同期男性健康体检者28例作为对照组。所有研究对象均行睡眠呼吸监测、血生化指标及一般情况记录,并行双能X线吸收法(DXA)测定骨密度值。根据低通气指数(AHI)及最低血氧饱和度(LSaO₂)将OSAHS组分组,比较各组间骨量变化、生化指标的差异以及OSAHS组并发症与骨量变化的关系。结果 ① 对照组与OSAHS组比较,两组间骨量变化无明显统计学差异(χ²=0.262, P>0.05),轻中度组与重度组两组间骨量变化无明显统计学差异(χ²=2.508, P>0.05),轻中度低氧组与重度低氧组两组间骨量变化有统计学意义(χ²=5.073, P<0.05);② 对照组与OSASH组比较,体质量指数(BMI)、胆固醇(TG)存在差异有统计学意义(P<0.05, P<0.05),其余各项指标无明显统计学意义,按LSaO₂分组,轻中度低氧组与重度低氧组两组间TG差异有统计学意义(P<0.05),其余各项指标无统计学意义;③ OSAHS组合并血脂异常13例,高血压5例,2型糖尿病1例,糖耐量异常7例,并发症与骨量变化的对比显示无明显统计学意义。结论 中年男性OSAHS患者的骨量变化与健康人群比较差异无统计学意义,与AHI相比LSaO₂对骨量变化影响较大。

An investigation on the test of bone mineral density in middle-aged men with obstructive sleep apnea hypopnea syndrome

Objective To investigate the changes of bone mineral density (BMD) in middle-aged men with obstructive sleep apnea hypopnea syndrome (OSAHS), in order to explore the correlation between OSASH and BMD. Methods A total of 48 OSASH cases were enrolled as the OSAHS group, and 28 healthy male served as the control group. All subjects were monitored with PSG. Blood biochemical and other indexes were tested. BMD was measured with DXA. Patients in the OSAHS group were subdivided according to values of AHI and LSaO₂. The changes of different indexes in different subgroups were compared, and the correlation between OSAHS BMD was analyzed. Results ① There was no statistical difference in BMD between the OSAHS group and control group (χ²=0.262, P>0.05), and between mild-to-moderate OSAHS subgroup and severe OSAHS subgroup (χ²=2.508, P>0.05), but there was difference between mild-to-moderate hypoxia subgroup and severe hypoxia subgroup (χ²=5.073, P<0.05). ② There were statistical differences in body weight index (BMI) and triglyceride (TG) between the control group and OSASH group (both P<0.05). There was statistical difference in TG between the mild-to-moderate hypoxia and severe hypoxia subgroups (P<0.05). ③ In the OSAHS group, 13 cases were complicated with dyslipidemia, 5 cases with high blood pressure, 1 case with type II diabetes, 7 cases with abnormal glucose tolerance. Conclusion The change of bone mass density is not correlated with OSASH in middle-aged male. LSaO₂ has larger effects than AHI on the change of bone mass density.