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[持续气道正压通气对阻塞性睡眠呼吸暂停低通气综合征合并2型糖尿病患者血糖水平未治疗时变化的影响]

[Effects of continuous positive airway pressure upon the un-treatment hour changes of blood glucose level in patients with obstructive sleep apnea hypopnea syndrome and type 2 diabetes].

作者信息

Wei Cui-ying, Wang Hui-min, Wang Yun-Zhi, Wei Feng, Xue Ye-xia, Zhang Zhu, Ji Li-nong, Han Fang

机构信息

Department of Endocrine Medicine, First Affiliated Hospital, Baotou Medical College, Baotou 014010, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Apr 24;92(16):1116-8.

PMID:22781771
Abstract

OBJECTIVE

To assess the effects of short-term continuous positive airway pressure (CPAP) upon un-treatment hour glucose control via a continuous glucose monitoring system (CGMS) in patients with obstructive sleep apnea hypopnea syndrome and type 2 diabetes (OWD).

METHODS

A total of 23 case of hospitalized OWD were recruited. CGMS was applied for 2 days before and 4 days during CPAP treatment. The treatment hour (6 h, 0:00 - 6:00) and un-treatment hour (14 h, 6:00 - 22:00) glucose level and glucose variability were analyzed. Insulin resistance was assessed with fasting plasma blood glucose (FPG), plasma insulin (FINS) and homeostatic model assessment of insulin resistance index (HOMA-IR).

RESULTS

The short-term CPAP treatment corrected sleep-disordered breathing and induced significant decreases of treatment and un-treatment hour glucose level ((7.07 ± 2.02) mmol/L vs (6.34 ± 1.57) mmol/L, (8.04 ± 1.99) mmol/L vs (7.64 ± 1.81) mmol/L, both P < 0.05). Glucose variability of treatment and un-treatment hours significantly decreased after CPAP treatment (0.41 ± 0.24 vs 0.29 ± 0.18, 1.02 ± 0.50 vs 0.78 ± 0.45, all P < 0.05). Short-term treatment also induced an increase of insulin sensitivity, as indicated by a significant decrease of HOMA-IR (4.02 ± 2.07 vs 3.08 ± 1.58, P < 0.05).

CONCLUSION

Short-term CPAP treatment in OWD may improve not only insulin resistance but also blood glucose and glucose variability during treatment and un-treatment hours.

摘要

目的

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)患者未治疗时段血糖控制的影响。

方法

共纳入23例住院的OWD患者。在CPAP治疗前2天和治疗期间4天应用CGMS。分析治疗时段(6小时,0:00 - 6:00)和未治疗时段(14小时,6:00 - 22:00)的血糖水平及血糖变异性。采用空腹血糖(FPG)、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。

结果

短期CPAP治疗纠正了睡眠呼吸紊乱,并使治疗时段和未治疗时段的血糖水平显著降低((7.07 ± 2.02)mmol/L对(6.34 ± 1.57)mmol/L,(8.04 ± 1.99)mmol/L对(7.64 ± 1.81)mmol/L,均P < 0.05)。CPAP治疗后,治疗时段和未治疗时段的血糖变异性显著降低(0.41 ± 0.24对0.29 ± 0.18,1.02 ± 0.50对0.78 ± 0.45,均P < 0.05)。短期治疗还使胰岛素敏感性增加,表现为HOMA-IR显著降低(4.02 ± 2.07对3.08 ± 1.58,P < 0.05)。

结论

OWD患者短期CPAP治疗不仅可改善胰岛素抵抗,还可改善治疗时段和未治疗时段的血糖及血糖变异性。

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