2 型糖尿病合并阻塞性睡眠呼吸暂停患者的动脉僵硬度。

Arterial stiffness in people with Type 2 diabetes and obstructive sleep apnoea.

机构信息

Nordsjaellands University Hospital, Hilleroed, Denmark.

Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark.

出版信息

Diabet Med. 2018 Oct;35(10):1391-1398. doi: 10.1111/dme.13666. Epub 2018 May 24.

DOI:10.1111/dme.13666

PMID:29763980

Abstract

AIMS

To examine whether people with Type 2 diabetes with concurrent obstructive sleep apnoea have increased arterial stiffness as compared with people with Type 2 diabetes without obstructive sleep apnoea.

METHODS

In a study with a case-control design, 40 people with Type 2 diabetes and treatment-naïve moderate to severe obstructive sleep apnoea (Apnoea-Hypopnoea Index ≥15) and a control group of 31 people with Type 2 diabetes without obstructive sleep apnoea (Apnoea-Hypopnoea Index <5) were examined. Obstructive sleep apnoea status was evaluated using the ApneaLink + home-monitoring device (Resmed Inc., San Diego, CA, USA), providing the Apnoea-Hypopnoea Index scores. Arterial stiffness was assessed according to carotid-femoral pulse wave velocity using the Sphygmocor device and the oscillometric Mobil-O-Graph (I.E.M. GmbH, Stolberg, Germany).

RESULTS

Carotid-femoral pulse wave velocity was not significantly different between participants with Type 2 diabetes with obstructive sleep apnoea and those without obstructive sleep apnoea (10.7±2.2 m/s vs 10.3±2.1 m/s; P=0.513), whereas oscillometric pulse wave velocity was significantly higher in participants with Type 2 diabetes with obstructive sleep apnoea than in those without obstructive sleep apnoea (9.5±1.0 m/s vs 8.6±1.4 m/s; P=0.002). In multiple regression analysis, age (P=0.002), gender (men; P=0.018) and HbA (P=0.027) were associated with carotid-femoral pulse wave velocity, and systolic blood pressure (P=0.004) and age (P<0.001) were associated with oscillometric pulse wave velocity. After adjustment, presence of obstructive sleep apnoea was not independently associated with pulse wave velocity whether assessed by tonometry or oscillometry.

CONCLUSION

In conclusion, the present study did not find an age- and blood pressure-independent association between moderate to severe obstructive sleep apnoea and arterial stiffness in non-sleepy people with Type 2 diabetes. (Clinical trial registration number: NCT02482584).

摘要

目的

研究 2 型糖尿病合并阻塞性睡眠呼吸暂停（OSA）患者与 2 型糖尿病不合并 OSA 患者相比，动脉僵硬度是否增加。

方法

采用病例对照研究，纳入 40 例未经治疗的中重度 OSA（呼吸暂停低通气指数≥15）的 2 型糖尿病患者和 31 例 2 型糖尿病无 OSA（呼吸暂停低通气指数<5）患者。使用 ApneaLink+家庭监测仪（美国圣地亚哥的 Resmed Inc.）评估 OSA 状态，提供呼吸暂停低通气指数评分。使用 Sphygmocor 装置和振荡式 Mobil-O-Graph（德国 Stolberg 的 I.E.M. GmbH）评估动脉僵硬度。

结果

2 型糖尿病合并 OSA 患者与不合并 OSA 患者的颈股脉搏波速度无显著差异（10.7±2.2 m/s 比 10.3±2.1 m/s；P=0.513），但 2 型糖尿病合并 OSA 患者的振荡式脉搏波速度显著高于不合并 OSA 患者（9.5±1.0 m/s 比 8.6±1.4 m/s；P=0.002）。多元回归分析显示，年龄（P=0.002）、性别（男性；P=0.018）和糖化血红蛋白（HbA）（P=0.027）与颈股脉搏波速度相关，收缩压（P=0.004）和年龄（P<0.001）与振荡式脉搏波速度相关。调整后，无论通过张力测量法还是振荡测量法评估，阻塞性睡眠呼吸暂停的存在与脉搏波速度均无独立相关性。