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目的 :研究阻塞性睡眠呼吸暂停综合征 ( OSAS)患者血清瘦素水平及其与胰岛素抵抗的关系。方法 :所有研究对象经过夜间 5～ 7h的多导睡眠图 ( PSG)监测 ,采用反映胰岛素敏感性的指标 Homeostasis Model Assessment( HOMA)、胰岛素抵抗指数 ( HOMA-IR)和反映胰岛 β细胞功能的指标空腹 β细胞功能指数 ( FBCI)分别检测 :1 1 7例中重度OSAS患者 ( AHI≥ 2 0 ) ;2 1 3例轻度 OSAS患者 ( 5≤ AHI<2 0 ) ;3 1 0例对照 ( AHI<5 )的胰岛素敏感性和 β细胞分泌功能 ,用放射免疫法测定血清瘦素水平。结果 :1中重度及轻度OSAS患者空腹胰岛素水平高于对照组。 2中重度 OSAS及轻度患者瘦素水平均高于对照组。 3中重度 OSAS患者组 HOMA胰岛素敏感指数、空腹 β细胞功能指数均高于轻度组OSAS患者组及对照组。 4OSAS患者血清瘦素水平与体格指数、胰岛素、HOMA胰岛素抵抗指数及空腹 β细胞功能指数正相关。结论 :OSAS患者血清瘦素水平可能与其胰岛素抵抗有关。
Objective: To study the relationship between serum leptin levels and insulin resistance in patients with obstructive sleep apnea syndrome (OSAS). Methods: All subjects were monitored by polysomnography (PSG) at 5 ~ 7h at night, using indicators of homeostasis model assessment (HOMA), insulin resistance index (HOMA-IR) and indicators reflecting pancreatic β-cell function Fasting β-cell function index (FBCI) were detected in 117 cases of moderate and severe OSAS patients (AHI ≥ 20), 21 cases of mild OSAS (5 ≤ AHI <20), 31 cases of control (AHI <5) insulin sensitivity and β-cell secretion, serum leptin levels were measured by radioimmunoassay. Results: 1 fasting insulin levels in moderate and severe OSAS patients were higher than those in control group. 2 moderate and severe OSAS and mild patients with leptin levels were higher than the control group. HOMA insulin sensitivity index and fasting β-cell function index in moderate and severe OSAS patients were higher than those in mild OSAS patients and controls. The level of serum leptin in patients with OSAS positively correlated with body mass index, insulin, HOMA insulin resistance index and fasting β-cell function index. Conclusion: Serum leptin levels in OSAS patients may be related to their insulin resistance.