Biomedical Dept of Internal and Specialist Medicine, DIBIMIS, Section of Pneumology, University of Palermo, Palermo, Italy.
Eur Respir J. 2012 May;39(5):1136-43. doi: 10.1183/09031936.00151110. Epub 2011 Nov 10.
The metabolic syndrome shows a variable prevalence in obstructive sleep apnoea (OSA), and its association with insulin resistance or excessive daytime sleepiness in OSA is unclear. This study assessed the following in consecutive patients with newly diagnosed OSA: 1) the prevalence of metabolic syndrome; and 2) its association with insulin resistance and daytime sleepiness. Metabolic syndrome (National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III criteria), insulin resistance (Homeostatic Model Assessment (HOMA) index, n = 288) and daytime sleepiness (Epworth Sleepiness Scale) were assessed in 529 OSA patients. The prevalence of metabolic syndrome was 51.2%, which increased with OSA severity. Each metabolic syndrome component correlated with apnoea/hypopnoea index, but only blood pressure retained significance after correction for confounders. Both obesity and OSA contributed to metabolic abnormalities, with different sex-related patterns, since diagnosis of metabolic syndrome was significantly associated with neck circumference, age, body mass index and lowest arterial oxygen saturation in males, and with age and arousal index in females. The number of metabolic syndrome components increased with HOMA index (p<0.001). Prevalence of sleepiness was the same in patients with and without metabolic syndrome. The metabolic syndrome occurs in about half of "real-life" OSA patients, irrespective of daytime sleepiness, and is a reliable marker of insulin resistance.
代谢综合征在阻塞性睡眠呼吸暂停（OSA）中表现出不同的流行率，其与 OSA 中的胰岛素抵抗或日间嗜睡的关系尚不清楚。本研究在连续诊断为 OSA 的患者中评估了以下内容：1）代谢综合征的患病率；2）其与胰岛素抵抗和日间嗜睡的关系。在 529 例 OSA 患者中评估了代谢综合征（国家胆固醇教育计划成人治疗专家组（NCEP-ATP）III 标准）、胰岛素抵抗（稳态模型评估（HOMA）指数，n = 288）和日间嗜睡（Epworth 嗜睡量表）。代谢综合征的患病率为 51.2%，随着 OSA 严重程度的增加而增加。每个代谢综合征成分与呼吸暂停/低通气指数相关，但仅血压在纠正混杂因素后仍具有统计学意义。肥胖和 OSA 都导致代谢异常，具有不同的性别相关模式，因为代谢综合征的诊断与男性的颈围、年龄、体重指数和最低动脉血氧饱和度以及女性的年龄和觉醒指数显著相关。HOMA 指数越高，代谢综合征成分的数量也越多（p<0.001）。有代谢综合征的患者和无代谢综合征的患者嗜睡的发生率相同。代谢综合征在“真实生活”中的 OSA 患者中约占一半，无论白天是否嗜睡，且是胰岛素抵抗的可靠标志物。
