探讨阻塞性睡眠呼吸暂停综合征患者血清中维生素D的临床意义

发布时间：2018-07-02 15:11

本文选题：阻塞性睡眠呼吸暂停综合征 + 2型糖尿病　；参考：《山西医科大学》2012年硕士论文

【摘要】：目的：测定阻塞性睡民呼吸暂停综合征(OSAS)患者以及阻塞性睡眠呼吸暂停合并2型糖尿病患者血清中的维生素D的水平,探讨维生素D在OSAS引起2型糖尿病中所起的作用以及临床意义。方法：74名受试者来自于山西医科大学第二附属医院睡眠监测中心、内分泌科及体检中心,根据中华医学会制定的OSAS诊断标准及2型糖尿病的诊断标准,将受试者分为以下四组：健康对照组19名、单纯2型糖尿病组14名、OSAS合并2型糖尿病组14名、单纯OSAS组27名,并根据其睡眠呼吸紊乱指数(AHI)分为轻中重组,其中轻度组9名,中度组8名,重度组10名。所有受试者均记录性别、年龄、身高、体重、胸围、腰围、臀围、吸烟饮酒史、糖尿病高血.压家族史,经过至少7个小时的多导睡眠监测(PSG),次日分析得到呼吸紊乱指数(AHI)、夜间最低氧饱和度(SaO2min),并于清晨抽取空腹肘部静脉血,测定空腹血糖(fasting blood glucose FPG)、糖化血红蛋白(HbAlC)以及血清维生素D的水平。结果：(1)与对照组相比,单纯2型糖尿病组、OSAS合并糖尿病组、轻中重度OSAS组中的HbAlC、FPG明显升高,差异具有统计学意义；重度OSAS组较轻度OSAS组明显升高,差异具有统计学意义(P0.05)(2)单纯糖尿病组、单纯OSAS组、OSAS合并糖尿病组受试者的血清维生素D水平明显低于对照组,OSAS合并糖尿病组明显低于单纯糖尿病组,差异具有统计学意义(P0.05)；(3)相关分析：维生素D与BMI、AHI、糖化血红蛋白、空腹血糖呈负相关(相关系数分别为r=-0.309,-0.516,-0.421,-0.458),与最低血氧饱和度呈正相关(相关系数r=0.349)。结论：(1)OSAS患者常出现糖代谢紊乱,与AHI、BMI、平均血氧相关；(2)2型糖尿病患者存在体内维生素,D的降低；(3) OSAS患者体内维生素D水平较低,可能于其间歇低氧而影响维生素D的吸收与代谢；4)维生素D缺乏可引起糖代谢紊乱,而OSAS患者体内低水平的维生素D可能是OSAS引起糖代谢紊乱的原因之一。
[Abstract]:Objective: to determine the serum vitamin D levels in patients with obstructive sleep apnea syndrome (OSAS) and patients with obstructive sleep apnea (OSAS) and type 2 diabetes mellitus. To investigate the role and clinical significance of vitamin D in type 2 diabetes induced by OSAS. Methods Sleep monitoring center, endocrine department and physical examination center of the second affiliated Hospital of Shanxi Medical University were included. According to the diagnostic criteria of OSAS and type 2 diabetes mellitus developed by the Chinese Medical Association. The subjects were divided into the following four groups: healthy control group (n = 19), type 2 diabetes group (n = 14) and OSAS group (n = 27). There were 8 cases in moderate group and 10 cases in severe group. Sex, age, height, weight, chest circumference, waist circumference, hip circumference, smoking and drinking history, diabetes mellitus were recorded in all subjects. After at least 7 hours of polysomnography (PSG), respiratory disturbance index (AHI), nocturnal minimum oxygen saturation (SaO2min) were obtained, and fasting elbow venous blood was drawn in the morning. Fasting blood glucose (fasting blood glucose), glycosylated hemoglobin (HbAlC) and serum vitamin D levels were measured. Results: (1) compared with the control group, the level of HbAlCU FPG in the mild, moderate and severe OSAS group was significantly higher than that in the control group, while that in the severe OSAS group was significantly higher than that in the mild OSAS group, and that in the severe OSAS group was significantly higher than that in the mild OSAS group. The difference was statistically significant (P0.05) (2) the serum vitamin D levels in the OSAS patients with diabetes were significantly lower than those in the control group (P0.05), and the difference was statistically significant (P0.05). (3) correlation analysis: there was a negative correlation between vitamin D and BMIAHI, glycosylated hemoglobin, fasting blood glucose (r = 0.309) and a positive correlation between vitamin D and minimum oxygen saturation (r = 0.349). Conclusion: (1) the disorder of glucose metabolism is often found in OSAS patients, which is related to AHIBMI, mean blood oxygen, (2) the decrease of vitamin D in patients with type 2 diabetes mellitus, and (3) the low level of vitamin D in patients with OSAS. It is possible that vitamin D deficiency may cause glucose metabolism disorder due to intermittent hypoxia. However, low vitamin D level in patients with OSAS may be one of the causes of glucose metabolism disorder caused by OSAS.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R56;R587.1

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