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阻塞性睡眠呼吸暂停扰乱肥胖个体的血糖控制。

Obstructive Sleep Apnea Disrupts Glycemic Control in Obese Individuals.

机构信息

Sleep Medicine Center & Department of Otolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany.

Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University, 55099 Mainz, Germany.

出版信息

Medicina (Kaunas). 2022 Nov 5;58(11):1602. doi: 10.3390/medicina58111602.

Abstract

The link between obstructive sleep apnea (OSA) and obesity, and their common comorbidities such as diabetes mellitus (DM) or cardiovascular diseases, is not fully understood. The aim of this study was to investigate the possible association of OSA severity in obese individuals with polysomnography-based sleep parameters, as well as C-reactive protein (CRP) and glycated hemoglobin (HbA1c) serum levels. Polysomnographic recordings and blood samples were retrospectively compared between a group of 23 adult obese individuals with mild OSA (apnea-hypopnea index (AHI) = 7.5 (5.5-12.5)/h, age = 42.57 ± 11.44 years, 16 male, 7 female, body mass index (BMI) = 37.35 ± 3.88 kg/m²) and an age-, sex-, and BMI-matched group of individuals with moderate or severe OSA (AHI 41.5 (25.7-71.8)/h, age = 43.43 ± 11.96 years, 16 male, 7 female, BMI = 37.87 ± 4.74 kg/m²). All respiratory sleep-associated parameters were significantly higher in individuals with moderate and severe OSA compared to those with mild OSA. CRP levels did not differ between the two OSA severity groups. However, serum levels of HbA1c were significantly higher in the moderate/severe OSA group. Therefore, OSA severity may have a significant impact on glycemic control in obese individuals. Additionally, OSA severity did not appear to be further associated with systemic inflammation in obese individuals. Obese individuals may benefit not only from lifestyle modification, but also from OSA screening and treatment, particularly to prevent DM-associated disorders and conditions.

摘要

阻塞性睡眠呼吸暂停(OSA)与肥胖之间的联系,以及它们共同的合并症,如糖尿病(DM)或心血管疾病,尚未完全被理解。本研究的目的是探讨肥胖个体中 OSA 严重程度与基于多导睡眠图的睡眠参数、C 反应蛋白(CRP)和糖化血红蛋白(HbA1c)血清水平之间的可能关联。我们回顾性地比较了一组 23 名患有轻度 OSA(呼吸暂停-低通气指数(AHI)= 7.5(5.5-12.5)/小时,年龄= 42.57 ± 11.44 岁,16 名男性,7 名女性,体重指数(BMI)= 37.35 ± 3.88 kg/m²)和一组年龄、性别和 BMI 相匹配的患有中重度 OSA(AHI 41.5(25.7-71.8)/小时,年龄= 43.43 ± 11.96 岁,16 名男性,7 名女性,BMI = 37.87 ± 4.74 kg/m²)的肥胖个体的多导睡眠图记录和血液样本。与轻度 OSA 相比,中重度 OSA 个体的所有与呼吸相关的睡眠参数均显著升高。CRP 水平在两组 OSA 严重程度之间没有差异。然而,中度/重度 OSA 组的 HbA1c 血清水平显著升高。因此,OSA 严重程度可能对肥胖个体的血糖控制有显著影响。此外,OSA 严重程度似乎与肥胖个体的系统性炎症没有进一步关联。肥胖个体不仅可能受益于生活方式的改变,还可能受益于 OSA 的筛查和治疗,特别是为了预防与 DM 相关的疾病和状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ef3/9692310/4f4deed41361/medicina-58-01602-g001.jpg

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