上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

青少年肥胖人群发生阻塞性睡眠呼吸暂停低通气综合征的代谢相关高危因素

张豫文，石娟，张翼飞，顾卫琼，王卫庆，洪洁   

  1. 上海市内分泌代谢病临床医学中心，上海市内分泌代谢病研究所，上海交通大学医学院附属瑞金医院内分泌代谢病科，上海 200025
  • 出版日期:2016-12-28 发布日期:2016-12-29
  • 通讯作者: 洪洁，电子信箱：hongjie@medmail.com.cn。
  • 作者简介:张豫文 (1984—)，女，主治医师，硕士；电子信箱：bfzyw@163.com。
  • 基金资助:

    国家自然科学基金（81270931）

Metabolism-related high risk factors for obstructive sleep apnea hypopnea syndrome in adolescent obese patients

ZHANG Yu-wen, SHI Juan, ZHANG Yi-fei, GU Wei-qiong, WANG Wei-qing, HONG Jie   

  1. Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2016-12-28 Published:2016-12-29
  • Supported by:

    National Natural Science Foundation of China, 81270931

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摘要：

目的 ·探索青少年肥胖患者发生阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的代谢相关高危因素。方法 ·选择青少年肥胖患者共199例。所有患者经多导睡眠监测，以呼吸暂停低通气指数（AHI）评估OSAHS的严重程度；运用稳态模型计算胰岛素抵抗指数（HOMA-IR）；运用Bergman微小模型技术结合多样本静脉葡萄糖耐量试验计算胰岛素敏感性指数（SI）；利用CT结合软件测定腹部脂肪分布与含量；按OSAHS及其严重程度分组对比，利用回归分析预测该人群发生OSAHS的高危因素。结果 · OSAHS组的颈围、内脏脂肪面积（VAT）、血压、血糖、肝酶、血脂均显著高于非OSAHS组（均P<0.05）。其中，颈围、VAT、舒张压是OSAHS的独立危险因素。结论 ·导致青少年肥胖患者发生OSAHS的代谢相关高危因素是颈围的增大、内脏脂肪的堆积以及血压的升高。

关键词: 肥胖, 阻塞性睡眠呼吸暂停低通气综合征, 颈围, 腹部内脏脂肪面积, 血压

Abstract:

Objective · To explore the high risk factors for obstructive sleep apnea hypopnea syndrome (OSAHS) in adolescent obese patients. Methods · A total of 199 adolescent obese patients were enrolled. All patients underwent polysomnography (PSG). The severity of OSAHS was assessed with apnea hypopnea index (AHI). The homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated using steady-state model. Bergman mini-model technology and frequently sampled intravenous glucose tolerance test were used to calculate the insulin sensitivity index (SI). The abdominal fat distribution and content were measured with CT and specific software. Patients were stratified and compared by OSAHS and severity and regression analysis was used to predict the high risk factors for OSAHS in this population. Results · The OSAHS group had significantly larger neck circumference (NC) and higher visceral fat area (VAT), blood pressure, blood glucose, liver enzyme, and blood lipid than the non-OSAHS group (P<0.05). Among above factors, NC, VAT, and diastolic blood pressure (DBP) are independent risk factors for OSAHS. Conclusion · Larger NC and higher VAT and DBP are high risk factors for OSAHS in adolescent obese patients.

Key words: obesity, obstructive sleep apnea hypopnea syndrome, neck circumference, visceral adipose tissue, blood pressure