Huang Weijun, Liu Yuenan, Wang Xiaoting, Li Xinyi, Liu Yupu, Zou Jianyin, Xu Huajun, Zhu Huaming, Yi Hongliang, Guan Jian, Yin Shankai
Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Nat Sci Sleep. 2021 Jun 4;13:739-749. doi: 10.2147/NSS.S311130. eCollection 2021.
Slow-wave sleep (SWS) and obstructive sleep apnea (OSA) have attracted recent research attention. However, their joint effects on insulin resistance (IR) remain unclear. This study explored whether SWS influences the relationship between OSA and IR.
We enrolled potential participants in our sleep center from 2007 to 2019. We collected demographic and clinical characteristics and determined IR status. SWS was derived from polysomnography data. Logistic regression analysis was used to reveal the associations between SWS and IR.
In all, 6966 participants (5709 OSA and 1257 primary snoring [PS] subjects) were enrolled. Less SWS increased the risk of IR in OSA patients but not in PS patients. OSA patients with SWS <6.5% were more likely to have IR than were those with SWS >21.3%. OSA was an independent risk factor for IR after adjusting for potential confounding factors. In stratified analyses according to the percentage of SWS, OSA patients with SWS <6.5% had an odds ratio for IR of 2.461 (95% CI, 2.018-3.002) compared to the PS group after adjusting for potential confounders.
Less SWS is associated with higher odds for IR in OSA patients but not in PS patients. OSA is independently associated with IR. In addition, OSA combined with an extreme lack of SWS has a more harmful effect on the status of IR than OSA itself.
慢波睡眠（SWS）和阻塞性睡眠呼吸暂停（OSA）最近受到了研究关注。然而，它们对胰岛素抵抗（IR）的联合影响仍不清楚。本研究探讨了慢波睡眠是否会影响阻塞性睡眠呼吸暂停与胰岛素抵抗之间的关系。
我们在2007年至2019年期间招募了睡眠中心的潜在参与者。我们收集了人口统计学和临床特征，并确定了胰岛素抵抗状态。慢波睡眠数据来自多导睡眠图。采用逻辑回归分析来揭示慢波睡眠与胰岛素抵抗之间的关联。
总共招募了6966名参与者（5709名阻塞性睡眠呼吸暂停患者和1257名原发性打鼾[PS]患者）。较少的慢波睡眠增加了阻塞性睡眠呼吸暂停患者胰岛素抵抗的风险，但原发性打鼾患者未出现这种情况。慢波睡眠<6.5%的阻塞性睡眠呼吸暂停患者比慢波睡眠>21.3%的患者更易出现胰岛素抵抗。在调整潜在混杂因素后，阻塞性睡眠呼吸暂停是胰岛素抵抗的独立危险因素。在根据慢波睡眠百分比进行的分层分析中，调整潜在混杂因素后，与原发性打鼾组相比，慢波睡眠<6.5%的阻塞性睡眠呼吸暂停患者发生胰岛素抵抗的比值比为2.461（95%CI，2.018 - 3.002）。
较少的慢波睡眠与阻塞性睡眠呼吸暂停患者较高的胰岛素抵抗几率相关，但原发性打鼾患者并非如此。阻塞性睡眠呼吸暂停与胰岛素抵抗独立相关。此外，阻塞性睡眠呼吸暂停合并极度缺乏慢波睡眠对胰岛素抵抗状态的危害比阻塞性睡眠呼吸暂停本身更大。
