Background： For patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） and type 2 diabetes mellitus （T2DM）, the night sleep interruption and intermittent hypoxia due to apnea or hypopnea may induce glyce...Background： For patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） and type 2 diabetes mellitus （T2DM）, the night sleep interruption and intermittent hypoxia due to apnea or hypopnea may induce glycemic excursions and reduce insulin sensitivity. This study aimed to investigate the effect of continuous positive airway pressure （CPAP） therapy in patients with OSAHS and T2DM. Methods： Continuous glucose monitoring system （CGMS） was used in 40 patients with T2DM and newly diagnosed OSAHS. The measurements were repeated after 30 days of CPAP treatment. Subsequently, insulin sensitivity and glycohemoglobin （HbAlc） were measured and compared to the pretreatment data. Results： After CPAP therapy, the CGMS indicators showed that the 24-h mean blood glucose （MBG） and the night time MBG were significantly reduced （P 〈 0.05 and P = 0.03, respectively）. The mean ambulatory glucose excursions （MAGEs） and the mean of daily differences were also significantly reduced （P 〈 0.05 and P = 0.002, respectively） compared to pretreatment levels. During the night, MAGE also significantly decreased （P = 0.049）. The differences between the highest and lowest levels of blood glucose over 24 h and during the night were significantly lower than prior to CPAP treatment （P 〈 0.05 and P = 0.024, respectively）. The 24 h and night time durations of high blood glucose （〉7.8 mmol/L and 〉 11.1 mmol/L） decreased （P 〈 0.05 and P 〈 0.05, respectively） after the treatment. In addition, HbA 1 c levels were also lower than those before treatment （P 〈 0.05）, and the homeostasis model assessment index of insulin resistance was also significantly lower than before CPAP treatment （P = 0.034）. Conclusions： CPAP therapy may have a beneficial effect on improving not only blood glucose but also upon insulin sensitivity in T2DM patients with OSAHS. This suggests that CPAP may be an effective treatment for T2DM in addition to intensive diabetes management.展开更多
目的探讨慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆内皮素-1(ET-1)、一氧化氮(NO)与肺动脉高压的关系。方法选择COPD患者53例,其中合并肺动脉高压患者18例;OSAHS患者50例,其中合并肺动脉高压患者14例...目的探讨慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆内皮素-1(ET-1)、一氧化氮(NO)与肺动脉高压的关系。方法选择COPD患者53例,其中合并肺动脉高压患者18例;OSAHS患者50例,其中合并肺动脉高压患者14例和重叠综合征(COPD合并OSAHS,即OS)患者25例,其中合并肺动脉高压患者12例,应用超声心动图评估肺动脉压,放射免疫法测定血浆ET-1水平,硝酸酶还原法测定NO水平,比较3组患者睡眠呼吸暂停严重程度及睡眠时缺氧程度。结果 3组患者睡眠呼吸暂停低通气指数(apneahypopnea index,AHI)、血氧饱和度(SaO2)<90%时间占总睡眠时间百分比(cumulative percentage of sleep time withSaO2below90%,TSaO2<90%)、最低血氧饱和度(MinSaO2)比较,差异均有统计学意义(P<0.01),OS组与COPD组、OSAHS组相比夜间MinSaO2降低(P<0.05)、TSaO2<90%增加,差异均有统计学意义(P<0.05);AHI升高亦有统计学意义(P<0.05)。3组合并肺动脉高压患者NO和ET-1水平比较,差异均有统计学意义(P<0.01)。OS合并肺动脉高压患者较未合并肺动脉高压患者ET-1水平升高,NO水平降低,差异均有统计学意义(P<0.05)。结论 OS患者较单纯的COPD和单纯OSAHS患者夜间缺氧更明显,更易形成肺动脉高压。血浆NO降低、ET-1升高与肺动脉压升高有一定关系。展开更多
文摘Background： For patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） and type 2 diabetes mellitus （T2DM）, the night sleep interruption and intermittent hypoxia due to apnea or hypopnea may induce glycemic excursions and reduce insulin sensitivity. This study aimed to investigate the effect of continuous positive airway pressure （CPAP） therapy in patients with OSAHS and T2DM. Methods： Continuous glucose monitoring system （CGMS） was used in 40 patients with T2DM and newly diagnosed OSAHS. The measurements were repeated after 30 days of CPAP treatment. Subsequently, insulin sensitivity and glycohemoglobin （HbAlc） were measured and compared to the pretreatment data. Results： After CPAP therapy, the CGMS indicators showed that the 24-h mean blood glucose （MBG） and the night time MBG were significantly reduced （P 〈 0.05 and P = 0.03, respectively）. The mean ambulatory glucose excursions （MAGEs） and the mean of daily differences were also significantly reduced （P 〈 0.05 and P = 0.002, respectively） compared to pretreatment levels. During the night, MAGE also significantly decreased （P = 0.049）. The differences between the highest and lowest levels of blood glucose over 24 h and during the night were significantly lower than prior to CPAP treatment （P 〈 0.05 and P = 0.024, respectively）. The 24 h and night time durations of high blood glucose （〉7.8 mmol/L and 〉 11.1 mmol/L） decreased （P 〈 0.05 and P 〈 0.05, respectively） after the treatment. In addition, HbA 1 c levels were also lower than those before treatment （P 〈 0.05）, and the homeostasis model assessment index of insulin resistance was also significantly lower than before CPAP treatment （P = 0.034）. Conclusions： CPAP therapy may have a beneficial effect on improving not only blood glucose but also upon insulin sensitivity in T2DM patients with OSAHS. This suggests that CPAP may be an effective treatment for T2DM in addition to intensive diabetes management.
文摘目的探讨慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆内皮素-1(ET-1)、一氧化氮(NO)与肺动脉高压的关系。方法选择COPD患者53例,其中合并肺动脉高压患者18例;OSAHS患者50例,其中合并肺动脉高压患者14例和重叠综合征(COPD合并OSAHS,即OS)患者25例,其中合并肺动脉高压患者12例,应用超声心动图评估肺动脉压,放射免疫法测定血浆ET-1水平,硝酸酶还原法测定NO水平,比较3组患者睡眠呼吸暂停严重程度及睡眠时缺氧程度。结果 3组患者睡眠呼吸暂停低通气指数(apneahypopnea index,AHI)、血氧饱和度(SaO2)<90%时间占总睡眠时间百分比(cumulative percentage of sleep time withSaO2below90%,TSaO2<90%)、最低血氧饱和度(MinSaO2)比较,差异均有统计学意义(P<0.01),OS组与COPD组、OSAHS组相比夜间MinSaO2降低(P<0.05)、TSaO2<90%增加,差异均有统计学意义(P<0.05);AHI升高亦有统计学意义(P<0.05)。3组合并肺动脉高压患者NO和ET-1水平比较,差异均有统计学意义(P<0.01)。OS合并肺动脉高压患者较未合并肺动脉高压患者ET-1水平升高,NO水平降低,差异均有统计学意义(P<0.05)。结论 OS患者较单纯的COPD和单纯OSAHS患者夜间缺氧更明显,更易形成肺动脉高压。血浆NO降低、ET-1升高与肺动脉压升高有一定关系。
