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体脂指数可有效预测阻塞性睡眠呼吸暂停中的胰岛素抵抗:来自横断面和纵向研究的证据

Body Fat Indices as Effective Predictors of Insulin Resistance in Obstructive Sleep Apnea: Evidence from a Cross-Sectional and Longitudinal Study : BFI as Predictors of IR in OSA.

机构信息

Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China.

Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China.

出版信息

Obes Surg. 2021 May;31(5):2219-2230. doi: 10.1007/s11695-021-05261-9. Epub 2021 Feb 10.

Abstract

PURPOSE

Body fat indices serve as predictive markers of insulin resistance (IR) in metabolic diseases. IR is common in obstructive sleep apnea (OSA). However, whether body fat indices have utility as predictors of IR in OSA remain unknown.

MATERIALS AND METHODS

A longitudinal study was conducted in 46 patients undergoing bariatric surgery to explore the relationship between IR and body fat indices. Then, a cross-sectional study was performed to evaluate the relationships between body fat indices and IR, and receiver operating characteristic (ROC) curves were generated. Body indices, homeostasis model assessment index of insulin resistance (HOMA-IR), biological indicators, and polysomnographic variables were collected.

RESULTS

In the longitudinal study, significant relationships were found between remission of IR and changes in visceral adiposity index (VAI) (r = 0.452, P < 0.05) and triglyceride-glucose index (TyG) (r = 0.650, P < 0.01). In the cross-sectional study, lipid accumulation product (LAP) (best cutoff value: 30.16, area under the curve (AUC) = 0.728, P < 0.001) and TyG (best cutoff value: 8.54, AUC = 0.740, P < 0.001) were indicators of IR in normal weight group. In overweight/obese group, body mass index (BMI) (best cutoff value: 27.69 AUC = 0.707, P < 0.001) and waist circumference (WC) (best cutoff value: 97.25, AUC = 0.708, P < 0.001) were markers of IR. TyG showed better ability to predict IR in normal weight females (best cutoff value: 8.39 AUC = 0.813, P < 0.001).

CONCLUSIONS

Body fat indices are predictive markers of IR in patients with OSA.

摘要

目的

体脂指数可作为代谢性疾病胰岛素抵抗(IR)的预测指标。IR 在阻塞性睡眠呼吸暂停(OSA)中很常见。然而,体脂指数是否可作为 OSA 中 IR 的预测指标尚不清楚。

材料和方法

对 46 例行减重手术的患者进行了一项纵向研究,以探讨 IR 与体脂指数之间的关系。然后进行了一项横断面研究,以评估体脂指数与 IR 之间的关系,并生成了受试者工作特征(ROC)曲线。收集了身体指数、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、生物标志物和多导睡眠图变量。

结果

在纵向研究中,IR 缓解与内脏脂肪指数(VAI)(r = 0.452,P < 0.05)和甘油三酯-葡萄糖指数(TyG)(r = 0.650,P < 0.01)的变化呈显著相关。在横断面研究中,脂质蓄积产物(LAP)(最佳截断值:30.16,曲线下面积(AUC)= 0.728,P < 0.001)和 TyG(最佳截断值:8.54,AUC = 0.740,P < 0.001)是正常体重组 IR 的指标。在超重/肥胖组中,体重指数(BMI)(最佳截断值:27.69,AUC = 0.707,P < 0.001)和腰围(WC)(最佳截断值:97.25,AUC = 0.708,P < 0.001)是 IR 的标志物。TyG 对正常体重女性 IR 的预测能力更好(最佳截断值:8.39,AUC = 0.813,P < 0.001)。

结论

体脂指数是 OSA 患者 IR 的预测指标。

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