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阻塞性睡眠呼吸暂停（ＯＳＡＳ）与肥胖、高血压、高血脂及糖代谢异常之间的关系近年来受到广泛重视。但因上述诸因素相互混淆，这为澄清ＯＳＡＳ与单一疾患之间的关系带来很大困难。本研究应用多元逐步回归分析探讨了ＯＳＡＳ患者１６３例呼吸暂停指数（ＡＩ）与胰岛素抵抗、高胰岛素血症及糖代谢异常之间的关系。患者均行整夜多导睡眠仪及口服糖耐量（ＯＧＴＴ）检查；以ＯＧＴＴ时胰岛素反应曲线下面积（ＡＵＣｉｎｓｕｌｉｎ）作为胰岛素抵抗的指标。结果：①直线相关分析表明，ＡＵＣｇｌｕｃｏｓｅ（血糖反应曲线下面积）及ＡＵＣｉｎｓｕｌｉｎ均与ＡＩ呈显著相关；②分别以ＡＵＣｇｌｕｃｏｓｅ及ＡＵＣｉｎｓｕｌｉｎ为依存因子建立的多元回归方程中均包括ＡＩ；尤其在后一方程中，ＡＩ对ＡＵＣｉｎｓｕｌｉｎ的贡献率仅次于身高体重指数。因此，作者认为ＯＳＡＳ为高胰岛素血症及糖代谢异常的重要致病因子，且其作用独立于肥胖、糖尿病家族史及年龄等混淆因素。
The relationship between obstructive sleep apnea (OSAS) and obesity, hypertension, hyperlipidemia and abnormal glucose metabolism has drawn great attention in recent years. However, these factors are mutually confusing, which makes it very difficult to clarify the relationship between OSAS and single disease. In this study, multivariate stepwise regression analysis of 163 OSAS patients with apnea index (AI) and insulin resistance, hyperinsulinemia and the relationship between abnormal glucose metabolism. All patients underwent overnight polysomnography and oral glucose tolerance (OGTT) examination. The area under the curve of insulin response at the time of OGTT (AUCinsulin) was used as an indicator of insulin resistance. Results: ①The linear correlation analysis showed that both AUCglucose and AUCinsulin were significantly correlated with AI; ②Amoglucose and AUCinsulin-dependent multivariate regression equations were all included AI; especially in the latter equation , AI contribution to AUCinsulin second only to height and body mass index. Therefore, the authors believe that OSAS is an important virulence factor for hyperinsulinemia and glycometabolism, and its effect is independent of confounders such as obesity, family history of diabetes and age.