阻塞性睡眠呼吸暂停低通气综合征对血糖、血脂及C反应蛋白的影响

doi:10.6040/j.issn.1673-3770.0.2017.182

摘要/Abstract

摘要： 目的探讨血糖、血脂及C反应蛋白(CRP)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的相关性。方法根据呼吸暂停低通气指数(AHI),将103例OSAHS患者分为轻度组(n=36)、中度组(n=35)和重度组(n=32),另选同期健康体检的35例健康人群作为对照组,检测并比较4个研究对象组血氧饱和度(SpO₂)、血糖、血脂指标和CRP水平,并分析AHI、SpO₂与血糖、血脂指标和CRP水平的相关性。结果与对照组比较,轻、中、重度组最低和平均SpO₂均显著下降(P<0.01);与对照组比较,轻、中、重度组空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗(IR)、CRP、甘油三酯(TG)和中、重组低密度脂蛋白胆固醇(LDL-C)水平均显著升高(P<0.01),且随OSAHS严重程度的增加逐渐上升(P<0.01);与对照组比较,轻、中、重度组高密度脂蛋白胆固醇(HDL-C)均显著减低,且随OSAHS的严重程度的增加逐渐降低(P<0.05或P<0.01);重度组总胆固醇(TC)水平显著升高(P<0.05),4个组间差异无统计学意义(P>0.05);AHI与FINS、IR呈正相关(P<0.01);最低SpO₂及平均SpO₂与FINS、IR无相关性(P>0.05);AHI与HDL-C呈负相关,与TG、CRP呈正相关(P<0.05或P<0.01),最低SpO₂及平均SpO₂与HDL-C呈正相关,与TG、CRP呈负相关(P<0.05或P<0.01)。结论 OSAHS对血糖、血脂代谢指标及CRP水平的影响较大,且OSAHS越严重,血糖、血脂代谢指标及CRP水平变化越明显,此外AHI、低SpO₂分别是OSAHS严重程度分型依据和病理特征,且AHI、SpO₂与FINS、IR、HDL-C、TG、CRP存在一定相关性,因此早期对OSAHS患者上述指标进行筛查,对OSAHS病情的评估具有一定的参考价值。

关键词: C反应蛋白, 血糖, 血脂, 低通气, 睡眠呼吸暂停,阻塞性

Abstract: Objective We aimed to assess the correlation between obstructive sleep apnea-hypopnea syndrome(OSAHS)and changes in blood glucose, serum lipid, and C-reactive protein(CRP)levels. Methods Based on the apnea-hypopnea index(AHI), 103 patients with OSAHS were divided into 3 groups, with mild(n=36), moderate(n=35), and severe disease(n=32). Thirty-five healthy subjects served as controls. Arterial oxygen saturation(SpO₂), blood glucose, serum lipid levels, and CRP levels were compared. We analyzed the correlation between AHI and SpO₂, blood glucose, serum lipid, and CRP levels. Results Compared with the control group, the lowest and average SpO₂ levels were significantly lower in all groups of OSAHS(P<0.01). Insulin resistance(IR)was high in all groups; furthermore, the fasting blood glucose(FBG), fasting insulin(FINS), CRP, and serum triglyceride(TG)levels were also significantly higher in these patients(P<0.05). Low-density lipoprotein cholesterol(LDL-C)levels were significantly higher in the moderate and severe groups(P<0.01), and increased linearly with the severity of OSAHS(P<0.01). High-density lipoprotein cholesterol(HDL-C)levels were significantly lower in all OSAHS groups and decreased linearly with disease severity(P<0.01). Total cholesterol(TC)levels were significantly higher in the severe group(P<0.05), but there was no significant difference between the 4 groups(P>0.05). AHI correlated positively with FINS levels and IR(P<0.01); it did not correlate with the lowest and average SpO₂, FINS levels, and IR(P>0.05). AHI correlated negatively with HDL-C levels(P<0.05)and positively with TG and CRP levels(P<0.01). The 山东大学耳鼻喉眼学报31卷6期 -任涛,等.阻塞性睡眠呼吸暂停低通气综合征对血糖、血脂及C反应蛋白的影响 \=-lowest and average SpO₂ correlated positively with HDL-C levels(P<0.05)and negatively with TG and CRP levels(P<0.01). Conclusion OSAHS has a strong influence on blood glucose, serum lipid, and CRP levels. The severity of OSAHS is correlated to blood glucose, serum lipid, and CRP levels. In addition, when the severity of OSAHS is based on AHI, low SpO₂ is a typical pathological feature in all groups. Besides, AHI is strongly correlated to SpO₂, IR, as well as FINS, HDL-C, TG, and CRP levels. Therefore, early screening for these markers of OSAHS may be significant in the evaluation of the disease.

Key words: C-reactive protein, Serum lipid, Hypopnea, Blood glucose, Sleep apnea, obstructive

中图分类号:

R766.7

任涛,唐以军,王梅芳,刘岩,钱鑫. 阻塞性睡眠呼吸暂停低通气综合征对血糖、血脂及C反应蛋白的影响[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 53-57.

REN Tao, TANG Yijun, WANG Meifang, LIU Yan, QIAN Xin.. Effect of obstructive sleep apnea-hypopnea syndrome on blood glucose, serum lipid, and C-reactive protein levels.[J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(6): 53-57.

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