摘要
目的探讨血清IL-6、TNF-α与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的关系,及其在2型糖尿病(T2DM)合并OSAHS发生及病情进展过程中的意义。方法选取2020年6月至2022年6月住院的T2DM患者106例,根据睡眠监测结果将患者分为单纯2型糖尿病组(T2DM组,n=26)、T2DM合并轻度OSAHS组(轻度OSAHS组,n=28)、T2DM合并中度OSAHS组(中度OSAHS组,n=24)和T2DM合并重度OSAHS组(重度OSAHS组,n=28)。比较4组患者的一般资料、低通气次数(AHI)、最低血氧饱和度(LSaO_(2))、空腹血糖(FPG)、空腹血清胰岛素(FINS)、糖化血红蛋白(HbA1c)、平均血糖(24 hMBG)、平均血糖标准差(SDBG)、最大血糖波动幅度(LAGE)、平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及胰岛素抵抗指数(HOMA-IR)。结果与T2DM组相比,轻、中、重度OSAHS组,FPG、FINS、HbA1c、HOMA-IR 24 hMBG、SDBG、LAGE、MAGE、MODD、IL-6、TNF-α水平更高(P<0.05)。经Pearson相关性分析显示,轻、中、重度OSAHS组24 hMBG、SDBG、LAGE、MAGE、MODD与AHI呈正相关(r=0.528~0.862,P<0.05),与LSaO_(2)无相关性(P>0.05);IL-6、TNF-α与AHI呈正相关(r=0.612~0.659,P<0.05)、与LSaO_(2)呈负相关(r=-0.542~-0.328,P<0.05)。多因素Logistic回归分析显示,24 hMBG、MAGE、IL-6、TNF-α与AHI呈独立相关(P<0.05)。结论T2DM合并OSAHS患者体内炎症水平更高,糖代谢紊乱、血糖波动大、胰岛素抵抗更严重。
Objective To investigate the relationships of serum interleukin 6(IL-6)and tumor necrosis factor-α(TNF-α)levels to obstructive sleep apnea hypopnea syndrome(OSAHS)and their significance in the occurrence and development of type 2 diabetes mellitus(T2DM)complicated by OSAHS.Methods According to the sleep monitoring results,106 T2DM patients hospitalized in our hospital from June 2020 to June 2022 were divided into T2DM group(n=26),mild OSAHS group(n=28),moderate OSAHS group(n=24),and severe OSAHS group(n=28).The general data,apnea hypopnea index(AHI),lowest arterial oxygen saturation(LSaO_(2)),fasting plasm glucose(FPG),fasting serum insulin(FINS),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR),24 hour mean blood glucose(24 hMBG),standard deviation of blood glucose(SDBG),largest amplitude of glycemic excursion(LAGE),mean amplitude of glycemic excursion(MAGE),mean of daily difference(MODD),IL-6 and TNF-αwere compared between patients with T2DM alone and those with T2DM and OSAHS.Results Compared with the T2DM group,the levels of FPG,FINS,HbA1c,HOMA-IR,24 hMBG,SDBG,LAGE,MAGE,MODD,IL-6 and TNF-αincreased in the mild,moderate and severe OSAHS groups(P<0.05).Pearson correlation analysis showed that 24hMBG,SDBG,LAGE,MAGE and MODD levels were positively correlated with AHI(0.528-0.862,P<0.05),but were not related to LSaO_(2) in the OSAHS groups(P>0.05).Furthermore,IL-6 and TNF-αlevels were positively correlated with AHI(r=0.612-0.659,P<0.05),but negatively associated with LSaO_(2)(r=-0.542--0.328,P<0.05).Multivariate logistic regression analysis showed that 24 hMBG,MAGE,IL-6 and TNF-αwere independently correlated with AHI(P<0.05).Conclusion T2DM patients with OSAHS have severe inflammation,glucose metabolism disorder,blood glucose fluctuation and insulin resistance.
作者
蔡霞
赖晓阳
宣睿
李经
CAI Xia;LAI Xiao-yang;XUAN Rui;LI Jing(Department of Endocrinology and Metabolism,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)
出处
《实用临床医学（江西）》
CAS
2023年第5期5-9,共5页
Practical Clinical Medicine
基金
江西省卫健委科技计划(20204234)。
