Sleep-disordered breathing, glucose intolerance, and insulin resistance - The Sleep Heart Health Study
Sleep-disordered breathing, glucose intolerance, and insulin resistance - The Sleep Heart Health Study
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DOI：
10.1093/aje/kwh261
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发表时间：
2004-09-15
影响因子：
5
通讯作者：
Resnick, HE
中科院分区：
文献类型：
--
作者：
Punjabi, NM;Shahar, E;Resnick, HE
临床研究表明，睡眠呼吸障碍 (SDB) 与葡萄糖不耐受和胰岛素抵抗有关。然而，在现有研究中，研究人员并未严格控制混杂变量来评估 SDB 与葡萄糖代谢受损之间的独立关系。本研究的目的是确定参与睡眠心脏健康研究 (1994-1999) 的社区居民受试者 (n = 2,656) 中 SDB 是否与葡萄糖不耐受和胰岛素抵抗相关。 SDB 通过呼吸障碍指数和睡眠期间的氧饱和度测量来表征。口服葡萄糖耐量试验期间测量的空腹和 2 小时血糖水平用于评估血糖状态。相对于呼吸障碍指数小于 5.0 次事件/小时（参考类别）的受试者，轻度 SDB（5.0-14.9 次事件/小时）和中度至重度 SDB（大于或等于 15 次事件/小时）受试者的调整比值比为 1.27（95% 置信区间：0.98、1.64）和 1.46（95% 置信区间：1.09， 1.97），分别针对空腹血糖不耐受（趋势 p < 0.01）。睡眠相关的低氧血症也与葡萄糖耐受不良相关，与年龄、性别、体重指数和腰围无关。这项研究的结果表明，SDB 与葡萄糖不耐受和胰岛素抵抗独立相关，并可能导致 2 型糖尿病。
Clinic-based studies suggest that sleep-disordered breathing (SDB) is associated with glucose intolerance and insulin resistance. However, in the available studies, researchers have not rigorously controlled for confounding variables to assess the independent relation between SDB and impaired glucose metabolism. The objective of this study was to determine whether SDB was associated with glucose intolerance and insulin resistance among community-dwelling subjects (n = 2,656) participating in the Sleep Heart Health Study (1994-1999). SDB was characterized with the respiratory disturbance index and measurements of oxygen saturation during sleep. Fasting and 2-hour glucose levels measured during an oral glucose tolerance test were used to assess glycemic status. Relative to subjects with a respiratory disturbance index of less than 5.0 events/hour (the reference category), subjects with mild SDB (5.0-14.9 events/hour) and moderate to severe SDB (greater than or equal to15 events/hour) had adjusted odds ratios of 1.27 (95% confidence interval: 0.98, 1.64) and 1.46 (95% confidence interval: 1.09, 1.97), respectively, for fasting glucose intolerance (p for trend < 0.01). Sleep-related hypoxemia was also associated with glucose intolerance independently of age, gender, body mass index, and waist circumference. The results of this study suggest that SDB is independently associated with glucose intolerance and insulin resistance and may lead to type 2 diabetes mellitus.