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脂质蓄积产物(LAP)与2型糖尿病患者的阻塞性睡眠呼吸暂停独立相关。

Lipid accumulation product (LAP) was independently associatedwith obstructive sleep apnea in patients with type 2 diabetes mellitus.

作者信息

Dong Lianqin, Lin Mingzhu, Wang Wengui, Ma Danyan, Chen Yun, Su Weijuan, Chen Zheng, Wang Shunhua, Li Xuejun, Li Zhibin, Liu Changqin

机构信息

The School of Clinical Medicine, Fujian Medical University, Fuzhou, 350000, China.

Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, No.55 Zhenhai Road, Xaimen, 361003, China.

出版信息

BMC Endocr Disord. 2020 Dec 9;20(1):179. doi: 10.1186/s12902-020-00661-x.

Abstract

BACKGROUND

Lipid accumulation product (LAP) is a new index based on a combination of waist circumference (WC) and serum triglycerides (TG) reflecting lipid accumulation. In this cross-sectional study, we aimed to explore whether LAP was independently associated with obstructive sleep apnea (OSA) in Type 2 diabetes mellitus (T2DM) patients.

METHODS

A cross-sectional study of 317 T2DM patients who underwent overnight polysomnography (PSG) tests was conducted. The clinical data between non-OSA group and OSA group were compared. Multivariable linear regression and multivariable logistic regression analyses were performed to determine associations of LAP, with apnea-hypopnea index (AHI) and OSA.

RESULTS

Among 317 patients, 219 (69.1%) were men, and the mean ages (±SD) were 51.4 (±13.5) years for men and 54.6 (±15.1) years for women (p = 0.067). The prevalence rates of OSA were 63.0% for men and 68.4% for women (p = 0.357). LAP (log-transformed) was significantly correlated with AHI (log-transformed), with the Pearson's correlation coefficient of 0.170 (p = 0.002). With adjustment for potential confounding factors, multivariate linear regression analyses showed the association of LAP with AHI was not statistically significant, with the adjusted linear regression coefficients (95% CI) of per SD increase of LAP for AHI (log-transformed) was 0.092 (- 0.011-0.194, p = 0.080). Multivariate logistic regression analyses showed LAP was significantly associated with increased risk of OSA, with the adjusted OR (95%CI) of per SD increase of LAP of 1.639 (1.032-2.604, p = 0.036). However, as constituents of LAP, neither TG nor WC was significantly associated with AHI and OSA.

CONCLUSION

LAP was independently associated with OSA and might be used as a potential OSA risk marker in T2DM patients, beyond the general index of obesity.

摘要

背景

脂质蓄积产物(LAP)是一种基于腰围(WC)和血清甘油三酯(TG)组合的反映脂质蓄积的新指标。在这项横断面研究中,我们旨在探讨LAP是否与2型糖尿病(T2DM)患者的阻塞性睡眠呼吸暂停(OSA)独立相关。

方法

对317例接受过夜多导睡眠图(PSG)检查的T2DM患者进行横断面研究。比较非OSA组和OSA组的临床资料。进行多变量线性回归和多变量逻辑回归分析,以确定LAP与呼吸暂停低通气指数(AHI)和OSA的相关性。

结果

317例患者中,男性219例(69.1%),男性平均年龄(±标准差)为51.4(±13.5)岁,女性为54.6(±15.1)岁(p = 0.067)。男性OSA患病率为63.0%,女性为68.4%(p = 0.357)。LAP(对数转换)与AHI(对数转换)显著相关,Pearson相关系数为0.170(p = 0.002)。在调整潜在混杂因素后,多变量线性回归分析显示LAP与AHI的相关性无统计学意义,LAP每增加1个标准差(95%CI)对AHI(对数转换)的调整线性回归系数为0.092(-0.011-0.194,p = 0.080)。多变量逻辑回归分析显示LAP与OSA风险增加显著相关,LAP每增加1个标准差的调整OR(95%CI)为1.639(1.032-2.604,p = 0.036)。然而,作为LAP的组成部分,TG和WC均与AHI和OSA无显著相关性。

结论

LAP与OSA独立相关,可能作为T2DM患者潜在的OSA风险标志物,超越一般肥胖指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b37c/7727244/b20da9a637f4/12902_2020_661_Fig1_HTML.jpg

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