上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (10): 1203-.doi: 10.3969/j.issn.1674-8115.2018.10.012

• 论著·临床研究 • 上一篇    下一篇

阻塞性睡眠呼吸暂停低通气综合征合并非酒精性脂肪性肝病患者血清脂肪代谢相关激素水平的研究

应晨 1，刘彩虹 2，胡家安 2，江石湖 3，徐志红 2，孙璟 2   

  1. 1. 上海交通大学医学院附属瑞金医院北院心血管病科，上海 201801；2.上海交通大学医学院附属瑞金医院老年病科，上海 200025；3.上海交通大学医学院附属瑞金医院消化内科，上海 200025
  • 出版日期:2018-10-28 发布日期:2018-11-18
  • 通讯作者: 孙璟，电子信箱：sj10535@rjh.com.cn。徐志红，电子信箱：zhihxu@163.com。为共同通信作者。
  • 作者简介:应晨（1987—），男，主治医师，硕士；电子信箱： shengye_ying@126.com。
  • 基金资助:
    上海市卫生和计划生育委员会重要薄弱学科建设项目（2015ZB0503）

Research on level of serum lipid metabolism related hormones in patients of obstructive sleep apnoea hypoxia syndrome combine with non-alcoholic fatty liver disease

YING Chen1, LIU Cai-hong2, HU Jia-an2, JIANG Shi-hu3, XU Zhi-hong2, SUN Jing2   

  1. 1. Department of Cardiology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China; 2. Department of Gerontology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 3. Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2018-10-28 Published:2018-11-18
  • Supported by:
    Weak Disciplines Construction Project FundingShanghai Municipal Commission of Health and Family Planning, 2015ZB0503

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摘要： 目的 ·评估阻塞性睡眠呼吸暂停低通气综合征（ obstructive sleep apnoea hypoxia syndrome, OSAHS）合并非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）患者血清脂肪代谢相关激素水平及其潜在作用。方法 ·选取因鼾症就诊患者，根据多导睡眠图监测及 NAFLD筛查分为 OSAHS+NAFLD组、OSAHS组、NAFLD组和对照组，比较血清脂肪代谢相关激素等指标；将 OSAHS患者分别依据呼吸暂停低通气指数（ apnea hypopnea index，AHI）和夜间最低动脉血氧饱和度（ minimum arterial oxygen saturation，MinSaO2）分为轻度、中度、重度 3组，比较 NAFLD发生情况；采用多元回归分析明确 NAFLD发病的独立预测因素。结果 · OSAHS组、NAFLD组及 OSAHS+NAFLD组的 AHI、MinSaO2、动脉血氧饱和度 < 90%的时间百分比（ TSaO2<90%）、体质量指数、脂联素、瘦素、高敏 C反应蛋白及脂多糖与对照组比较，差异均有统计学意义（均 P<0.05）；不同程度 OSAHS患者的 NAFLD发生率（ 17.0%、51.6%和 97.2%）比较，差异有统计学意义（ P0.006）；不同程度 MinSaO2的 OSAHS患者 NAFLD发生率（18.2%、57.1%和 91.9%）比较，差异也有统计学意义（P0.011）。多元回归分析显示体质量指数、AHI、脂联素为 NAFLD发病的独立预测因素（ P0.006，P0.020，P0.008）。结论 ·随着 OSAHS严重程度增大， NAFLD发病率逐渐升高； OSAHS合并 NAFLD患者血清脂联素、瘦素水平与 NAFLD病情严重程度有关。

关键词: 阻塞性睡眠呼吸暂停低通气综合征, 非酒精性脂肪性肝病, 脂联素, 瘦素

Abstract:

Objective · To assess the level of serum lipid metabolism related hormones in the patients of obstructive sleep apnoea hypoxia syndrome (OSAHS) combine with non-alcoholic fatty liver disease (NAFLD), and explore the potential role in the pathogenesis. Methods · Patients that main complaint for snoring were selected. According to polysomnography and NAFLD screening, the patients were divided as follows: OSAHS+NAFLD group, OSAHS group, NAFLD group, and control group, and the levels of serum lipid metabolism related hormones were measured. The patients with OSAHS were divided into three groups, i.e., mild, moderate and severe groups according to the degree of apnea hypopnea index (AHI) and minimal oxyhemoglobin saturation (MinSaO2) respectively. The statistical analysis about the morbidity of NAFLD in the patients with different OSAHS severity were analyzed. Multiple regression analysis was used to determine the independent predictors of NAFLD. Results · Significant differences were found in AHI, MinSaO2, the duration of hemoglobin desaturation (TSaO2<90%), body mass index, adiponectin, leptin, high sensitive C reactive protein and lipopolysaccharide (P<0.05 for all) among the groups of OSAHS, NAFLD and OSAHS+NAFLD. The morbidity of NAFLD exited statistical difference in the patients with different OSAHS severity (17.0%, 51.6% and 97.2%, P0.006), and the same trend was seen in the patients with different MinSaO2 severity (18.2%, 57.1% and 91.9%, P0.011). Multiple regression analysis showed that body mass index, AHI and adiponectin were independent predictors of the morbidity of NAFLD (P0.006，P0.020 and P0.008). Conclusion · The morbidity of NAFLD increases with the worsening of OSAHS. There is positive correlation between the severity and the level of serum adiponectin and leptin in the patients with OSAHS and NAFLD.

Key words: obstructive sleep apnoea hypoxia syndrome (OSAHS), non-alcoholic fatty liver disease (NAFLD), adiponectin, leptin

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