摘要
Objective:To investigate the associated pathogenesis of higher clinical coexistence of obstructive sleep apnea hypopnea syndrome (OSAHS) and metabolic syndrome (MS) in elderly snorers. Methods:Tnrough polysomnography examination, 69 elderly habitual snorers weredivided into simple snorers (control group) and OSAHS patients who were further divided into mild-to-moderate and severe OSAHS groups based on their apnea hypopnea index (AHI) and the lowest pulse oxygen saturation (LSpO2) during sleep respectively. The incidences of MS were compared among different groups. Correlation was analyzed among polysomnography parameters-AHI, LSpO2 and average pulse oxygen saturation (ASpO2),MS-associated parameters-fasting blood glucose (FBG),total cholesterol (TCH),triglyceride(TG),high-density lipoprotein cholesterol (HDL),low-density lipoprotein cholesterol (LDL),insulin and proinsulin (PI),HOMA index and blood pressure (Bp),as well as some body indexes-body mass index (BMI),waist circumference (WC) and neck circumference (NC).Results:Coexisting MS was found in 28% of all the OSAHS patients. The incidences of MS in severe OSAHS groups were significantly higher than in control group(P<0.05).Spearman correlation analysis indicated that HOMA index and PI were negatively correlated with nocturnalLSp O2 and ASpO2 significantly. There were no statistically significant correlation of HOMA index and PI with AHI. LSpO2 and ASpO2 were negatively correlated with BMI, WC, NC and diastolic Bp but positively correlated with TCH and HDL significantly. Univariate Logistic regression analysis suggested that the HOMA index and PI were risk factors of severe OSAHS and the odds ratio (OR) was 1.907(1.312～2.796)(P<0.01)and 1.703(1.162～2.497)(P<0.01)respectively. Multivariate stepwise Logistic regression analysis suggested that HOMA index and severe OSAHS were independently correlated and the OR was 1.949(1.311～3.181)(P<0.01).Conclusion:It was confirmed,from elderly snorers that there was a close association between OSAHS and MS, that IR might play an important role in the coexistence of OSAHS and MS, and that the OSAHS patients with a lower SpO2 were more susceptible to
