Wei Cui-Ying, Wang Hui-Ling, Li Jing, Dong Xiao-Song, An Pei, Ji Li-Nong, Wang Fang, Han Fang
Department of Respiritory Medicine, People's Hospital, Peking University, Beijing 100044, China.
Zhonghua Yi Xue Za Zhi. 2009 Oct 20;89(38):2686-9.
To assess the effect of short-term continuous positive airway pressure (CPAP) upon 24 h glucose control via a continuous glucose monitoring system (CGMS) in patients with obstructive sleep apnea hypopnea syndrome and type 2 diabetes (OWD).
Eleven cases of hospitalized OWD with age 43 - 70 (56 +/- 10) years old, body mass index 22.3 - 38.3 (28.5 +/- 5.5) kg/m(2) and apnea hypopnea index (AHI) 12 - 68 (45 +/- 23) times/h was recruited. CGMS was applied 2 days before and 4 days during CPAP treatment. The 24 h, treatment hours (6 h, 0:00-6:00) and non- treatment hours (18 h) glucose level and glucose variability were analyzed. Insulin resistance was assessed with fasting plasma blood glucose (FBG), plasma insulin (FINS) and homeostatic model assessment of insulin resistance index (HOMA-IR).
Short-term CPAP treatment corrected sleep disordered breathing, and induced significant decreases of 24 h and treatment hours blood glucose level [(7.97 +/- 1.31) vs (7.52 +/- 0.94) mmol/L, (7.24 +/- 1.51) vs (6.77 +/- 1.65) mmol/L, both P < 0.05). Glucose variability of 24 h and treatment hours and non-treatment hours significantly decreased after CPAP treatment (1.22 +/- 0.34 vs 0.89 +/- 0.28, 0.43 +/- 0.24 vs 0.31 +/- 0.18, 1.23 +/- 0.89 vs 0.49 +/- 0.26, all P < 0.05). Short-term treatment also induced increase of insulin sensitivity, as indicated by a significant decrease of HOMA-IR (3.65 +/- 1.93 vs 2.79 +/- 1.68, P < 0.05).
Short-term CPAP treatment in OWD may have an improving effect not only upon insulin resistance but also upon whole-day blood glucose and glucose variability.
通过连续血糖监测系统（CGMS）评估短期持续气道正压通气（CPAP）对阻塞性睡眠呼吸暂停低通气综合征合并2型糖尿病（OWD）患者24小时血糖控制的影响。
招募11例住院的OWD患者，年龄43 - 70（56±10）岁，体重指数22.3 - 38.3（28.5±5.5）kg/m²，呼吸暂停低通气指数（AHI）12 - 68（45±23）次/小时。在CPAP治疗前2天和治疗期间4天应用CGMS。分析24小时、治疗时间（6小时，0:00 - 6:00）和非治疗时间（18小时）的血糖水平和血糖变异性。通过空腹血浆血糖（FBG）、血浆胰岛素（FINS）和胰岛素抵抗稳态模型评估指数（HOMA-IR）评估胰岛素抵抗。
短期CPAP治疗纠正了睡眠呼吸紊乱，并导致24小时和治疗时间的血糖水平显著降低[（7.97±1.31）对（7.52±0.94）mmol/L，（7.24±1.51）对（6.77±1.65）mmol/L，均P<0.05]。CPAP治疗后，24小时、治疗时间和非治疗时间的血糖变异性显著降低（1.22±0.34对0.89±0.28，0.43±0.24对0.31±0.18，1.23±0.89对0.49±0.26，均P<0.05）。短期治疗还导致胰岛素敏感性增加，表现为HOMA-IR显著降低（3.65±1.93对2.79±1.68，P<0.05）。
OWD患者短期CPAP治疗不仅可能改善胰岛素抵抗，还可能改善全天血糖和血糖变异性。
