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目的通过观察OSAS患者血清同型半胱氨酸(Hcy)及胰岛素抵抗水平,分析两者之间的关系,进一步探讨OSAS患者高同型半胱氨酸血症及脑梗死发生的可能机制。方法按照便携式睡眠呼吸监测仪的监测数据,将入选者分为OSAS组(n=42)与对照组(n=40),检测入选者空腹血清Hcy、血糖、血清胰岛素水平,计算出胰岛素抵抗指数(HOMA-IR);比较2组血清Hcy、HOMA-IR水平,探讨血清Hcy与HO-MA-IR的关系。结果 OSAS组的血清Hcy、HOMA-IR水平较对照组显著增高(P<0.05),血清Hcy与HOMA-IR呈正相关(r=0.815,P<0.01),经偏相关分析校正体重指数及年龄的影响后它们之间仍呈正相关(r’=0.715,P<0.01)。结论 OSAS可能通过胰岛素抵抗的增强而影响Hcy的代谢,引起高同型半胱氨酸血症,进而导致脑梗死的发生。
Objective To investigate the relationship between serum homocysteine (Hcy) and insulin resistance in patients with OSAS and to explore the possible mechanism of hyperhomocysteinemia and cerebral infarction in patients with OSAS. Methods According to the monitoring data of portable sleep apnea monitor, the participants were divided into OSAS group (n = 42) and control group (n = 40), the fasting serum Hcy, blood glucose and serum insulin levels were measured to calculate the insulin resistance index (HOMA-IR). Hcy and HOMA-IR levels were compared between the two groups to investigate the relationship between serum Hcy and HO-MA-IR. Results The levels of serum Hcy and HOMA-IR in OSAS group were significantly higher than those in control group (P <0.05). The serum Hcy was positively correlated with HOMA-IR (r = 0.815, P <0.01). Correlation analysis of body mass index and age After the impact there is still a positive correlation between them (r ’= 0.715, P <0.01). Conclusion OSAS may affect the metabolism of Hcy through the increase of insulin resistance and cause hyperhomocysteinemia, leading to the occurrence of cerebral infarction.