摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆内脂素水平的变化及其影响因素。方法选取经多导睡眠监测仪(PSG)整夜监测诊断为中度、重度及极重度OSAHS(AHI>20次/h)的男性患者50例,对照组20例(AHI<5次/h),两组年龄、性别及体质量指数(BMI)相匹配。入选者均检测空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹胰岛素(FINS)和内脂素,测量身高、体重、腰围及臀围,计算BMI、腰臀比和胰岛素抵抗指数(HOMA-IR)。结果 OSAHS组血浆内脂素水平明显高于对照组([45.06±9.17)μg/Lvs(36.07±6.53)μg/L,P<0.001];中、重及极重度OSAHS组间血浆脂联素水平差异有显著性(P<0.001);内脂素与腰围、BMI、腰臀比、AHI、血氧饱和度(SaO2)<90%时间百分数、空腹血糖、胰岛素、HOMA-IR、TG及LDL-C均正相关,与平均SaO2、最低SaO2负相关。控制腰围、BMI、腰臀比、空腹血糖、胰岛素、HOMA-IR、TG及LDL-C后,血浆内脂素水平仍与AHI正相关(r'=0.331,P<0.05),与最低SaO2负相关(r'=0.301,P<0.05)。多元逐步回归分析表明,AHI是除了腰围以外血浆内脂素的独立影响因素。结论 OSAHS及其严重程度独立影响血浆内脂素水平。
【Objective】To investigate the changes and the influential factors of plasma visfatin levels in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）.【Methods】Fifty obese middle-aged men with OSAHS and twenty with nonapneic age-and body mass index（BMI）-matched obese men（control group） were recruited in the study by overnight polysomnography（PSG）.OSAHS patients defined as apnea-hypopnea index（AHI）20 events/h,control as AHI5 events/h.Blood example measurements included fasting plasma glucose（FPG）,total cholesterol（TC）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,fasting insulin（FINS） and fasting plasma visfatin.Anthropometric parameters included height,weight,waist circumference（WC） and hip circumference.BMI,waist/hip ratio（WHR） and homeostasis model assessment-insulin resistance index（HOMA-IR） were calculated.【Results】plasma visfatin level in OSAHS group was significantly higher than that in control group [（45.06±9.17）μg/L vs（36.07±6.53）μg/L,P 0.001].The levels of visfatin were also significantly different between the moderate,severe and very severe OSAHS patients（P 0.001）.Plasma visfatin levels were positively correlated with WC,BMI,WHR,AHI,percentage of sleep time with SaO290%,FPG,FINS,HOMA-IR,TG and LDL-C,but negatively correlated with the average SaO2 and minimum SaO2.Partial correlation analysis showed that plasma visfatin levels were still correlated positively with AHI（r＇=0.331,P 0.05） and correlated negatively with the minimum SaO2（r＇=0.301,P 0.05） after adjusted by WC,BMI,WHR,FPG,FINS,HOMA-IR,TG and LDL-C.Multiple stepwise regression analysis showed that AHI was an independent risk factor for the increase of plasma visfatin levels besides WC.【Conclusion】OSAHS and its severity independently influence the plasma visfatin level.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第16期2475-2478,共4页
China Journal of Modern Medicine
基金
河南省科技厅基金资助(No:82102310010)
