肥胖与阻塞性睡眠呼吸暂停低通气综合征的相关性研究——一例Wolfram综合征的家系研究-内科学(内分泌代谢病)专业论文.docxVIP

上海交通大学医学院硕士学位论文 上海交通大学医学院硕士学位论文 4 4 THE RESEARCH OF THE RELEVANCE BETWEEN OBESITY AND ITS RELATED METABOLIC SYNDROME AND OBSTRUCTIVE SLEEP APNEA HYPOPNEA SYNDROME (OSAHS) ABSTRACT Objective To assay the apnea hypopnea index (AHI) in subjects with obesity, and to explore the correlation between obstructive sleep apnea-hypopnea syndrome, metabolic syndrome and obesity and its related abnormal anthropometric parameters, glucose and lipid metabolism parameters and insulin sensitivity index etc. Methods All 63 obese (BMI ≥ 30kg/m2) patients (including 25 males and 38 females) performed polysomnowest (PSG). Apnea hypopnea index (AHI) was measured, meanwhile the anthropometric parameters, plasma glucose, serum insulin, liver enzymes, lipids and insulin homeostasis model assessment of insulin resistance (HOMA-IR) were also assessed. Furthermore, Bergman’s minimal model method with frequently sampled intravenous glucose tolerance test (FSIGTT) was performed in all our patients. Insulin resistance was determined from the insulin sensitivity index (SI) from the FSIGTT. Insulin secretion was determined during the FSIGTT by the acute insulin response to glucose (AIRg). The disposition index (DI), the product of AIRg and SI was used to determine whether AIRg was adequate to compensate for insulin resistance. In addition, abdominal CT PAGE PAGE 10 scan was used to evaluate the content of abdominal fat distribution with specialized software (Fat Scan). In this study, the relationship among OSAHS and obesity and its related metabolic syndrome and insulin resistance was analyzed. Results The morbidity of MS in obesity with OSAHS group was significantly higher than obesity without OSAHS group (85.7% vs 35.7%，P 0.01). After adjustment for age and BMI, neck circumference (NC), waist circumference (WC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), fasting serum insulin (FINS), HOMA-IR index, and abdominal viscer