[1]蒋晓真,奚峰,陈蕊华,等.2型糖尿病合并阻塞性睡眠呼吸暂停低通气 综合征患者颈动脉内膜中层厚度变化[J].国际内分泌代谢杂志,2016,36(05):292-295.[doi:10.3760/cma.j.issn.1673-4157.2016.05.02]
　Jiang Xiaozhen*,Xi Feng,Chen Ruihua,et al.Changes of carotid intima-media thickness in type 2 diabetic patients with obstructive sleep apnea-hypopnea syndrome[J].International Journal of Endocrinology and Metabolism,2016,36(05):292-295.[doi:10.3760/cma.j.issn.1673-4157.2016.05.02]
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2型糖尿病合并阻塞性睡眠呼吸暂停低通气 综合征患者颈动脉内膜中层厚度变化()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
36
期数:
2016年05期
页码:
292-295
栏目:
论著
出版日期:
2016-09-20

文章信息/Info

Title:
Changes of carotid intima-media thickness in type 2 diabetic patients with obstructive sleep apnea-hypopnea syndrome
作者:
蒋晓真; 奚峰; 陈蕊华; 邹宇峰; 顾哲; 周斌
201299 上海市浦东新区人民医院内分泌科(蒋晓真,陈蕊华,邹宇峰,顾哲,周斌),呼吸内科(奚峰)
Author(s):
Jiang Xiaozhen*;  Xi Feng;  Chen Ruihua;  Zou Yufeng;  Gu Zhe;  Zhou Bin
* Department of Endocrinology, Pudong New Area People's Hospital, Shanghai 201299, China
关键词:
2型糖尿病;  阻塞性睡眠呼吸暂停低通气综合征;  颈动脉内膜中层厚度
Keywords:
Tye 2 diabetes mellitus;  Obstructive sleep apnea-hypopnea syndrome;  Carotid intima-media thickness
DOI:
10.3760/cma.j.issn.1673-4157.2016.05.02
摘要:
目的 探讨2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者与单纯2型糖尿病患者颈动脉内膜中层厚度(IMT)的差异,及其与OSAHS严重程度的关系。方法 2013年9月至12月连续入组75例2型糖尿病住院患者,行身高、体重、腰围、臀围、血压、血糖、血脂、空腹胰岛素测定,以及颈动脉彩色多普勒超声检查和夜间多导睡眠仪监测(PSG)。将入组对象根据PSG结果分为糖尿病合并OSAHS组(OD组,n=42)和单纯糖尿病组(DM组,n=33),比较两组间各参数差异,并分析颈动脉IMT与其他临床参数之间的关系。结果 OD组的体重、腰围、空腹胰岛素(FINS)、稳态模型评估-胰岛素抵抗指数(HOMA-IR)、颈总动脉IMT、颈总动脉阻力指数(C-RI)、Epworth嗜睡评分(ESS评分)、氧减指数和呼吸暂停低通气指数(AHI)显著高于DM组(t=1.87～8.43,P均<0.05),睡眠最低氧饱和度(LSaO2)低于DM组(t=7.38,P<0.05)。单因素相关性分析显示,颈总动脉IMT与AHI、体重、体重指数、腰围、lgFINS、lgHOMA-IR、C-RI、氧减指数呈正相关(r=0.24～0.70,P均<0.05),与LSaO2呈负相关(r=-0.44,P<0.01)。多元线性逐步回归分析显示,校正了性别和年龄后,C-RI(β=0.35,P<0.01)、AHI(β=0.28,P=0.01)和lgFINS(β=0.21,P=0.04)是颈总动脉IMT的独立相关因素。结论 2型糖尿病合并OSAHS患者的颈总动脉IMT显著高于单纯2型糖尿病患者。OSAHS的严重程度与颈总动脉IMT的增厚密切相关。
Abstract:
Objective To investigate the difference of carotid intima-media thickness(IMT)between type 2 diabetic patients with or without obstructive sleep apnea-hypopnea syndrome(OSAHS), and the correlations between IMT and severity of OSAHS. Methods Seventy five inpatients with type 2 diabetes were consecutively enrolled from September to December, 2013. Height, weight, waist circumference, hip circumference, blood pressure, blood glucose, blood lipids and fasting insulin were measured. Moreover, all patients undertook the carotid ultrasonography and polysomnography test(PSG), and were divided into two groups: 42 patients with OSAHS(OD group), and 33 patients without OSAHS(DM group), according to the results of PSG. The differences of parameters between two groups were compared, and the correlations between IMT and other clinical characteristics were assessed. Results Body weight, waist circumference, fasting insulin(FINS), homeostasis model of assessment for insulin resistence index(HOMA-IR), carotid IMT, carotid resistance index(C-RI), Epworth sleepiness scale(ESS), oxygen reduction index(ODI), and apnea/hypopnea index(AHI)were higher(t=1.87-8.43,all P<0.05), while lowest oxygen saturation(LSaO2, t=7.38,P<0.05)was lower in OD group compared with those in DM group. Univariate analysis showed that carotid IMT was positively associated with AHI, body weight, body mass index, waist circumference, lgFINS, lgHOMA-IR,C-RI, and ODI(r=0.24-0.70,all P<0.05), and negatively correlated with LSaO2(r=-0.44, P<0.01). Results of multiple regression analysis indicated that C-RI(β=0.35,P<0.01),AHI(β=0.28,P=0.01)and lgFINS(β=0.21,P=0.04)were independent predictors of carotid IMT, after adjusting for sex and age.Conclusions Carotid IMT is increased in patients with both type 2 diabetes and OSAHS compared with patients with diabetes alone. The severity of OSAHS is associated with the increase of carotid IMT.

参考文献/References:

[1] Briançon-Marjollet A, Weiszenstein M, Henri M, et al. The impact of sleep disorders on glucose metabolism: endocrine and molecular mechanisms[J].Diabetol Metab Syndr,2015,7:25. DOI: 10.1186/s13098-015-0018-3.
[2] Drager LF, Polotsky VY, O'Donnell CP,et al. Translational approaches to understanding metabolic dysfunction and cardiovascular consequences ofobstructive sleep apnea[J].Am J Physiol Heart Circ Physiol,2015,309(7):H1101-H1111.DOI: 10.1152/ajpheart.00094.2015.
[3] Salepci B, Fidan A, Ketenci SC,et al. The effect of obstructive sleep apnea syndrome and snoring severity to intima-media thickening of carotid artery[J]. Sleep Breath, 2015,19(1):239-246. DOI: 10.1007/s11325-014-1002-0.
[4] Ciccone MM, Scicchitano P, Zito A,et al. Correlation between inflammatory markers of atherosclerosis and carotid intima-media thickness in obstructive sleep apnea[J]. Molecules,2014,19(2):1651-1662. DOI: 10.3390/molecules19021651.
[5] Araújo Lda S, Fernandes JF, Klein MR,et al. Obstructive sleep apnea is independently associated with inflammation and insulin resistance, but not with blood pressure, plasma catecholamines, and endothelial function in obese subjects[J]. Nutrition,2015,31(11-12):1351-1357. DOI: 10.1016/j.nut.2015.05.017.
[6] Priou P, Le Vaillant M, Meslier N,et al. Association between obstructive sleep apnea severity and glucose control in patients with untreated versus treated diabetes[J].J Sleep Res,2015,24(4):425-431. DOI: 10.1111/jsr.12278.
[7] Grima P, Guido M, Chiavaroli R,et al. Comparison of intima-media thickness and ophthalmic artery resistance index for assessing subclinical atherosclerosis in HIV-1-infected patients[J]. Cardiovasc Ultrasound,2011,9:9. DOI: 10.1186/1476-7120-9-9.
[8] Lind L, Wohlin M, Andren B,et al. The echogenicity of the intima-media complex in the common carotid artery is related to insulin resistance measured by the hyperinsulinemic clamp in elderly men[J]. Clin Physiol Funct Imaging,2013,33(2):137-142. DOI: 10.1111/cpf.12006.
[9] Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis[J]. Nature,2011,473(7347):317-325. DOI: 10.1038/nature10146.
[10] Adedayo AM, Olafiranye O, Smith D,et al. Obstructive sleep apnea and dyslipidemia: evidence and underlying mechanism[J].Sleep Breath,2014,18(1):13-18.DOI:10.1007/s11325-012-0760-9.

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备注/Memo

备注/Memo:
基金项目:上海市浦东新区科技发展基金创新基金(PKJ2013-Y28); 上海市浦东新区人民医院重点学科群基金(PRxkq2013-01) 通信作者:陈蕊华,Email: mizuno@yeah.net
更新日期/Last Update: 2016-11-20