Zhao Xin, Yu Xiaofeng, Xin Sixu, Zhang Wei, Zhang Xiaomei, Ji Linong
Endocrinology Department, Peking University International Hospital, Beijing, China.
Sleep Center Department, Peking University International Hospital, Beijing, China.
J Diabetes Res. 2021 Feb 10;2021:6630020. doi: 10.1155/2021/6630020. eCollection 2021.
To analyze the differences of early atherosclerosis indices in type 2 diabetes mellitus (T2DM) patients with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS) and explore the correlation between them, so as to provide a new clinical basis for the prevention and treatment of early atherosclerosis in patients with T2DM and OSAHS. . A prospective study was conducted in 312 patients with T2DM and snoring who were hospitalized in the Department of Endocrinology, Peking University International Hospital from January 2017 to January 2020. According to the monitoring results, 312 patients were divided into 4 groups including the control group (208 cases), mild OSAHS group (18 cases), moderate OSAHS group (38 cases), and severe OSAHS group (48 cases). Multivariate logistic regression analysis was used to analyze the early atherosclerosis indices including brachial-ankle pulse wave velocity (PWV) and ankle-brachial index (ABI) in patients with T2DM coexistence with different degrees of OSAHS. . (1) As the degree of OSAHS increased, ABI decreased gradually and was lower than that in the control group, but PWV increased and was higher than that in the control group ( < 0.05, respectively). (2) The apnea-hypopnea index (AHI) positively correlated with PWV (r = 0.36, < 0.05) and negatively correlated with ABI ( = -0.37, < 0.05). (3) Multivariate logistic regression showed that after adjusting for age, gender, duration, BMI, blood pressure, blood glucose, blood lipid, and other factors, OSAHS was a risk factor of lower extremity arterial disease (LEAD) in patients with T2DM. With the increase of degree of OSAHS, the risk of lower extremity atherosclerosis gradually increased. . OSAHS is an independent risk factor of LEAD in patients with T2DM, and with the increase of AHI, the ABI and PWV have changed, which provides a new clinical basis for the prevention and the treatment of early atherosclerosis in patients with T2DM and OSAHS.
分析2型糖尿病（T2DM）合并不同程度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者早期动脉粥样硬化指标的差异，探讨其相关性，为T2DM合并OSAHS患者早期动脉粥样硬化的防治提供新的临床依据。2017年1月至2020年1月在北京大学国际医院内分泌科住院的312例T2DM合并打鼾患者中进行前瞻性研究。根据监测结果，将312例患者分为4组，包括对照组（208例）、轻度OSAHS组（18例）、中度OSAHS组（38例）和重度OSAHS组（48例）。采用多因素logistic回归分析T2DM合并不同程度OSAHS患者的早期动脉粥样硬化指标，包括臂踝脉搏波速度（PWV）和踝臂指数（ABI）。（1）随着OSAHS程度加重，ABI逐渐降低且低于对照组，而PWV升高且高于对照组（均P<0.05）。（2）呼吸暂停低通气指数（AHI）与PWV呈正相关（r=0.36，P<0.05），与ABI呈负相关（r=-0.37，P<0.05）。（3）多因素logistic回归显示，校正年龄、性别、病程、BMI、血压、血糖、血脂等因素后，OSAHS是T2DM患者下肢动脉疾病（LEAD）的危险因素。随着OSAHS程度增加，下肢动脉粥样硬化风险逐渐升高。OSAHS是T2DM患者LEAD的独立危险因素，且随着AHI升高，ABI和PWV发生改变，为T2DM合并OSAHS患者早期动脉粥样硬化的防治提供了新的临床依据。
