Hormonal and metabolic profiles in subjects with obstructive sleep apnea syndrome and the acute effects of nasal continuous positive airway pressure (CPAP) treatment.
Hormonal and metabolic profiles in subjects with obstructive sleep apnea syndrome and the acute effects of nasal continuous positive airway pressure (CPAP) treatment.
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DOI：
10.1093/sleep/18.3.172
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发表时间：
1995-04
期刊：
影响因子：
5.6
通讯作者：
B. Cooper;J. White;L. Ashworth;K. Alberti;G. Gibson
中科院分区：
文献类型：
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作者：
B. Cooper;J. White;L. Ashworth;K. Alberti;G. Gibson
阻塞性睡眠呼吸暂停（OSA）患者夜间生长激素分泌受损，但代谢后果尚未报道。我们测量了6名患有OSA的肥胖非糖尿病男性患者的胰岛素、c肽、生长激素、皮质醇和胰高血糖素的血液水平，以及碳水化合物（葡萄糖、丙酮酸、乳酸、丙氨酸）和脂质代谢（甘油、非酯化脂肪酸（NEFA）、3-羟基丁酸）的中间代谢物。在第一项研究中，未经治疗的受试者出现频繁的呼吸暂停和随后的低氧血症。将激素和代谢物浓度与第二天晚上接受鼻腔持续气道正压通气（CPAP）有效治疗时的浓度进行比较。胰岛素、c肽、皮质醇和胰高血糖素的浓度无显著差异。我们证实OSA患者生长激素浓度显著降低，在CPAP夜间显著升高。葡萄糖、丙酮酸、乳酸、丙氨酸和甘油的夜间特征在两夜之间没有差异，但NEFA和3-羟基丁酸的浓度（两者都是脂肪分解的产物）在治疗夜明显更高。由于生长激素具有溶脂作用，因此研究结果表明，未经治疗的OSA患者抑制生长激素的分泌会导致脂肪分解受损，而鼻腔CPAP可迅速逆转这一过程。
Nocturnal secretion of growth hormone is impaired in patients with obstructive sleep apnea (OSA), but the metabolic consequences have not been reported. We measured blood levels of the hormones insulin, C-peptide, growth hormone, cortisol and glucagon together with the intermediary metabolites of carbohydrate (glucose, pyruvate, lactate, alanine) and lipid metabolism [glycerol, nonesterified fatty acids (NEFA), 3-hydroxybutyrate] in six obese nondiabetic men with OSA on two nights. In the first study, the untreated subjects showed frequent apneas and consequent hypoxemia. The hormone and metabolite concentrations were compared with those obtained on the following night when the subjects were treated effectively with nasal continuous positive airway pressure (CPAP). There were no significant differences in the concentrations of insulin, C-peptide, cortisol or glucagon. We confirmed a marked reduction in growth hormone concentrations in OSA, with a significant increase on the CPAP night. The nocturnal profiles of glucose, pyruvate, lactate, alanine and glycerol showed no differences between the two nights, but concentrations of NEFA and 3-hydroxybutyrate, both products of lipolysis, were significantly greater on the treatment night. Because growth hormone has a lipolytic action, the results suggest that suppression of secretion of growth hormone in untreated OSA results in impaired lipolysis, which is rapidly reversed by nasal CPAP.