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阻塞性睡眠呼吸暂停作为非糖尿病成年人胰岛素抵抗的一个危险因素。

Obstructive Sleep Apnea as a Risk Factor of Insulin Resistance in Nondiabetic Adults.

作者信息

Michalek-Zrabkowska Monika, Macek Piotr, Martynowicz Helena, Gac Pawel, Mazur Grzegorz, Grzeda Magda, Poreba Rafal

机构信息

Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland.

Department of Hygiene, Wroclaw Medical University, 7 Mikulicza-Radeckiego St., 50-345 Wroclaw, Poland.

出版信息

Life (Basel). 2021 Jan 13;11(1):50. doi: 10.3390/life11010050.

Abstract

OBJECTIVE

The aim of this research was to assess the relationship between prevalence and severity of obstructive sleep apnea (OSA) and insulin resistance among patients with increased risk of OSA without diabetes mellitus.

METHOD AND MATERIALS

our study group involved 102 individuals with suspected OSA, mean age 53.02 ± 12.37 years. Data on medical history, medication usage, sleep habits, sleep quality and daytime sleepiness, were obtained using questionnaires. All patients underwent standardized full night polysomnography. Serum fasting insulin and glucose concentration were analyzed, the homeostatic model assessment-insulin resistance (HOMA-IR) index was calculated.

RESULTS

polysomnographic study indicated that in the group with OSA mean values of apnea-hypopnea index (AHI), oxygen desaturation index (ODI), duration of SpO < 90% and average desaturation drop were significantly higher compared to the group without OSA, while the minimum SpO2 was significantly lower. The carbohydrate metabolism parameters did not differ within those groups. Significantly higher fasting insulin concentration and HOMA-IR index were found in the group with AHI ≥ 15 compared to the group with AHI < 15 and in the group with AHI ≥ 30 compared to the group with AHI < 30. Higher AHI and ODI were independent risk factors for higher fasting insulin concentration and higher HOMA-IR index. Increased duration of SpO2 < 90% was an independent risk factor for higher fasting glucose concentration.

CONCLUSIONS

Individuals with moderate to severe OSA without diabetes mellitus had a higher prevalence of insulin resistance.

摘要

目的

本研究旨在评估阻塞性睡眠呼吸暂停(OSA)患病率及严重程度与无糖尿病的OSA高风险患者胰岛素抵抗之间的关系。

方法与材料

我们的研究组包括102名疑似OSA患者,平均年龄53.02±12.37岁。通过问卷获取病史、用药情况、睡眠习惯、睡眠质量和日间嗜睡情况等数据。所有患者均接受标准化全夜多导睡眠监测。分析血清空腹胰岛素和葡萄糖浓度,计算稳态模型评估胰岛素抵抗(HOMA-IR)指数。

结果

多导睡眠监测研究表明,与无OSA组相比,OSA组的呼吸暂停低通气指数(AHI)、氧饱和度下降指数(ODI)、SpO₂<90%的持续时间和平均饱和度下降幅度的平均值显著更高,而最低SpO₂显著更低。这些组之间的碳水化合物代谢参数没有差异。与AHI<15的组相比,AHI≥15的组空腹胰岛素浓度和HOMA-IR指数显著更高;与AHI<30的组相比,AHI≥30的组也是如此。较高的AHI和ODI是空腹胰岛素浓度升高和HOMA-IR指数升高的独立危险因素。SpO₂<90%持续时间增加是空腹血糖浓度升高的独立危险因素。

结论

无糖尿病的中度至重度OSA患者胰岛素抵抗患病率更高。

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