Sleep-disordered breathing and insulin resistance in middle-aged and overweight men
Sleep-disordered breathing and insulin resistance in middle-aged and overweight men
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DOI：
10.1164/ajrccm.165.5.2104087
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发表时间：
2002-03-01
影响因子：
24.7
通讯作者：
Smith, PL
中科院分区：
文献类型：
--
作者：
Punjabi, NM;Sorkin, JD;Smith, PL
睡眠呼吸障碍是一种与日间功能受损相关的常见疾病，可能使个体易患与肥胖无关的代谢异常。本研究的主要目的是确定轻度肥胖但其他方面健康的个体中睡眠呼吸障碍的代谢后果和社区患病率。从社区招募了150名健康男性，没有糖尿病或心肺疾病。测量包括多导睡眠图，多次睡眠潜伏期试验，口服葡萄糖耐量试验，通过液体密度测定法测定体脂，空腹胰岛素和血脂。根据呼吸暂停低通气指数（AHI）的临界值，睡眠呼吸障碍的患病率在40%到60%之间。调整体重指数（BMI）和体脂百分比后，AHI大于或等于5次事件/小时与糖耐量受损或糖尿病糖耐量降低的风险增加相关（优势比，2.15; 95%CI，1.05-4.38）。葡萄糖耐量受损与睡眠呼吸障碍相关的氧饱和度下降（DeltaSa（O2））的严重程度有关。在调整体脂百分比、BMI和AHI后，血氧饱和度下降4%，葡萄糖耐量恶化的相关比值比为1.99（95%CI，1.11 - 3.56）。多变量线性回归分析显示，增加AHI与胰岛素抵抗恶化相关，与肥胖无关。因此，睡眠呼吸障碍是轻度肥胖男性的一种常见疾病，并与葡萄糖耐受不良和胰岛素抵抗独立相关。
Sleep-disordered breathing is a prevalent condition associated with impairment of daytime function and may predispose individuals to metabolic abnormalities independent of obesity. The primary objective of this study was to determine the metabolic consequences and community prevalence of sleep-disordered breathing in mildly obese, but otherwise healthy, individuals. One hundred and fifty healthy men, without diabetes or cardiopulmonary disease, were recruited from the community. Measurements included polysomnography, a multiple sleep latency test, an oral glucose tolerance test, determination of body fat by hydrodensitometry, and fasting insulin and lipids. The prevalence of sleep-disordered breathing, depending on the apnea-hypopnea index (AHI) cutoff, ranged from 40 to 60%. After adjusting for body mass index (BMI) and percent body fat, an AHI greater than or equal to5 events/h was associated with an increased risk of having impaired or diabetic glucose tolerance (odds ratio, 2.15; 95% CI, 1.05-4.38). The impairment in glucose tolerance was related to the severity of oxygen desaturation (DeltaSa(O 2)) associated with sleep-disordered breathing. For a 4% decrease in oxygen saturation, the associated odds ratio for worsening glucose tolerance was 1.99 (95% CI, 1.11 to 3.56) after adjusting for percent body fat, BMI, and AHI. Multivariable linear regression analyses revealed that increasing AHI was associated with worsening insulin resistance independent of obesity. Thus, sleep-disordered breathing is a prevalent condition in mildly obese men and is independently associated with glucose intolerance and insulin resistance.