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-  2018 

阻塞性睡眠呼吸暂停低通气综合征患者胰岛素抵抗状态及与外周血单个核细胞的内源性大麻素Ⅰ型受体蛋白表达的关系

DOI: doi:10.7507/1671-6205.201706024

Keywords: 阻塞性睡眠呼吸暂停低通气综合征, 胰岛素抵抗, 内源性大麻素, 糖尿病

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Abstract:

目的了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的糖代谢状态及其与内源性大麻素系统(ECS)的关系。方法共纳入 OSAHS 患者 64 例(轻度 18 例,中度 24 例,重度 22 例),对照 24 例。测量受试者体重指数、腰围、空腹血脂、血糖、血胰岛素、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、多导睡眠图(PSG)监测指标以及外周血单个核细胞(PBMC)的内源性大麻素Ⅰ型受体(CB1R)蛋白表达情况。结果OSAHS 组中糖尿病及空腹血糖受损者比例显著高于对照组糖尿病及空腹血糖受损者的比例(28.12% 比 8.33%)。随着呼吸暂停低通气指数(AHI)升高,各组 HOMA-IR 及 PBMC 的 CB1R 蛋白表达量逐渐升高,对照组、轻度 OSAHS 组、中度 OSAHS 组及重度 OSAHS 组 HOMA-IR 和 CB1R 蛋白相对表达量分别为 2.40±0.90、2.34±0.59、2.94±0.99、3.46±0.77 和 0.04±0.01、0.37±0.09、0.40±0.07、0.62±0.14。相关分析显示 HOMA-IR、AHI 及 CB1R 蛋白表达水平彼此之间呈显著正相关关系(P<0.05)。结论OSAHS 患者容易发生胰岛素抵抗及空腹血糖受损和糖尿病,且可能与伴随着 OSAHS 的 ECS 状态活化密切相关

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