OSAHS合并2型糖尿病患者炎症因子与颈动脉粥样硬化关系

摘要

目的 探讨2型糖尿病(T2DM)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清炎症因子水平与动脉粥样硬化的关系.方法 选取T2DM患者103例,根据多导睡眠检测结果分为T2DM合并OSAHS组(OSAHS组)及单纯T2DM组(非OSAHS组),并选取35例健康者为对照组.收集临床资料,检测血清中总胆固醇(TC)、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)水平及颈动脉超声检测颈动脉内膜中层厚度(IMT)值,并进行相关分析.结果 OSAHS组患者的腰围、BMI、FPG、HbA1c、IMT值、TNF-α及hs-CRP的水平明显高于非OSAHS组,差异有统计学意义(P＜0.05);Logistic回归分析表明,IMT值与TNF-α、hs-CRP独立相关(OR=1.20、2.21,P＜0.05).结论 T2DM合并OSAHS老年患者的血糖控制更差,大血管病变风险更大,可能与TNF-α及hs-CRP等炎症因子的升高密切相关.%Objective To investigate the relationship between serum inflammatory cytokines and atherosclerosis in type 2 diabetic patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods One hundred and three patients with type 2 diabetes were divided into OSAHS group (OSAHS group) and type 2 diabetes mellitus group (non-OSAHS group) according to the results of polysomnography(PSG),and 35 healthy subjects were selected as control group.Serum levels of total cholesterol,triglyceride,fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein (hs-CRP) and carotid intima-media thickness (IMT) were measured,and their relationship with OSAHS were analyzed.Results The waist circumference,BMI,FPG,HbA1c,IMT,TNF-α and CRP in OSAHS group were significantly higher than those in non-OSAHS group (P＜0.05).Logistic regression analysis showed that,IMT was independently associated with TNF-α and hs-CRP.Conclusion Patients of T2DM with OSAHS have poor blood glucose control and higher incidence of atherosclerosis.High levels of TNF-α and hs-CRP may be involved in the formation of atherosclerosis and plaque occurrence and development.