Feng Yuan, Guo Dong-Ying, Luo Miao, Xu Ting, Li Dan-Qing, Lei Ya-Hui, Li Tao-Ping
Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Oct 20;37(10):1315-1321. doi: 10.3969/j.issn.1673-4254.2017.10.06.
To assess the value of blood glucose at different time points in oral glucose tolerance test (OGTT), particularly one?hour post load plasma glucose (1 hPG), in evaluating glucose metabolism in adult patients with obstructive sleep apnea (OSA).
Eighty nine adultswith newly diagnosed OSA were analyzed retrospectively for sleep architecture assessed using polysomnography and glucose metabolism assessed by OGTT at different time points (0, 30, 60, 120, and 180 min). Pearson's correlatives and multiple linear regression models were established to investigate the correlations between glucose metabolism and other indices including sleep architecture, apnea hypopnea index (AHI), mean and lowest oxygen saturation (MSO and LSO) and obesity measurements.
The majority (67.4%) of the patients had abnormal 1 hPG, and 41.6% had abnormal 2 hPG. 1 hPG was positively correlated with neck circumference (r=0.245), abdomen circumference (r=0.231), systolic blood pressure (r=0.213), diastolic blood pressure (r=0.276) and AHI (r=0.324), and was negatively associated with MSO (r=-0.341) and LSO (r=-0.387) (all P<0.05). After controlling for age, BMI, neck and abdomen circumferences, 1 hPG was found to inversely correlated with MSO (r=-0.253, P=0.032) and LSO (r=-0.311, P=0.008). In non-obese OSA subgroup, 1 hPG was significantly associated with OSA-related indices, and regression models showed that LSO and N2 were the two most important contributors to 1 hPG (adjusted R=0.349, P<0.001); plasma glucose at other time points did not show such correlations.
1 hPG abnormality occurs earlier than 2 hPG in OSA patients. 1 hPG is significantly associated with OSA independent of obesity and may serve as a better index for measuring OSA-related glucose disorder.
评估口服葡萄糖耐量试验(OGTT)不同时间点的血糖值,尤其是负荷后1小时血糖(1 hPG),在评估成年阻塞性睡眠呼吸暂停(OSA)患者糖代谢中的价值。
回顾性分析89例新诊断的成年OSA患者,采用多导睡眠图评估睡眠结构,并通过OGTT在不同时间点(0、30、60、120和180分钟)评估糖代谢。建立Pearson相关性和多元线性回归模型,以研究糖代谢与其他指标之间的相关性,这些指标包括睡眠结构、呼吸暂停低通气指数(AHI)、平均和最低血氧饱和度(MSO和LSO)以及肥胖测量指标。
大多数患者(67.4%)1 hPG异常,41.6%患者2 hPG异常。1 hPG与颈围(r = 0.245)、腹围(r = 0.231)、收缩压(r = 0.213)、舒张压(r = 0.276)和AHI(r = 0.324)呈正相关,与MSO(r = -0.341)和LSO(r = -0.387)呈负相关(均P < 0.05)。在控制年龄、BMI、颈围和腹围后,发现1 hPG与MSO(r = -0.253,P = 0.032)和LSO(r = -0.311,P = 0.008)呈负相关。在非肥胖OSA亚组中,l hPG与OSA相关指标显著相关,回归模型显示LSO和N2是1 hPG的两个最重要影响因素(调整R = 0.349,P < 0.001);其他时间点的血糖未显示出此类相关性。
OSA患者中1 hPG异常比2 hPG出现更早。1 hPG与OSA显著相关,独立于肥胖,可能是衡量OSA相关糖代谢紊乱的更好指标。