老年男性阻塞性睡眠呼吸暂停综合征患者血清脂联素水平的变化

目的探讨老年男性阻塞性睡眠呼吸暂停综合征(OSAS)血清脂联素水平的变化。方法选择62例习惯性打鼾老年人行多导睡眠仪监测,根据呼吸暂停低通气指数(AHI)分为单纯打鼾组(对照组),OSAS组,以放射免疫法测定血清中脂联素水平。结果OSAS组的血清脂联素水平显著低于对照组(P<0.01)。而血清脂联素水平在轻度OSAS患者中即有显著降低(P<0.05),在中度和重度OSAS患者中进一步降低(P<0.01)。OSAS各亚组间的比较发现:中、重度组的血清脂联素水平均明显低于轻度OSAS组(P<0.05)。Pearson相关分析提示OSAS患者血清脂联素水平与AHI、体重指数(BMI)、腰围(WC)、颈围(NC)、反应性胰岛素抵抗的体内稳态模式(HOMA)指数呈负相关,与最低血氧饱和度(mini SpO2)呈正相关。偏相关分析提示血清脂联素水平与AHI呈负相关(r=-0.26,P<0.05),与SpO2呈正相关(r=0.24,P<0.05)。多元逻辑回归分析提示血清脂联素水平与OSAS独立相关。结论老年男性OSAS患者血清中脂联素水平较单纯打鼾者为低。

Serum adiponectin levels in elderly male patients with obstructive sleep apnea hypopnea syndrome

Objectives To investigate the levels of serum adiponectin in elderly male patients with obstructive sleep apnea syndrome(OSAS).Methods Through polysomnography examination,62 elderly male habitual snorers were divided into simple snorers(control group) and OSAS patients(OSAS group) who were further divided into mild,moderate and severe OSAS subgroups based on their apnea hypopnea index(AHI).The serum adiponectin levels were measured by radioimmunoassay.Results Serum adiponectin level was significantly lower in OSAS group than in control group(P<0.01).Compared with control group,the serum adiponectin levels declined statistically in mild OSAS subgroup(P<0.05),and further decreased in moderate OSAS subgroup(P<0.01) as well as in severe OSAS subgroup(P<0.01).Comparison among the subgroups of OSAS patients indicated that the serum adiponectin levels were significantly lower in both moderate and severe OSAS subgroups(all P<0.05).Pearson correlation analysis showed that in OSAS patients,serum adiponectin levels were negatively correlated with BMI,circumferences of waist(WC) and neck(NC),AHI and homeostasis model assessment(HOMA),but positively correlated with nadir pulse oxyhemoglobin saturation(nadir?SpO_2).A partial correlation analysis showed that the adiponectin levels were negatively correlated with AHI(r=-0.26,P<0.05) but positively correlated with nadir?SpO_2(r=0.24,P<0.05).Multiple logistic regression analysis indicated that the serum adiponectin level was independently associated with OSAS.Conclusions Serum adiponectin levels were significantly lower in OSAS patients than in simple snorers.OSAS may cause decrease in serum adiponectin level.