阻塞性睡眠呼吸暂停低通气综合征与代谢性疾病的研究进展

doi:10.20047/j.issn1673-7210.2023.08.10

摘要
图/表
参考文献(36)
相关文章 (15)

全文: PDF (534 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与代谢性疾病如肥胖、2型糖尿病、非酒精性脂肪肝双相相关。近年来，OSAHS发病率持续上升，对患者的身心健康造成严重危害。但在既往研究中，OSAHS与代谢性疾病相关的作用机制不够明确，OSAHS合并代谢性疾病的治疗方法也相对局限。近年来，OSAHS与代谢性疾病成为研究热点，共同发病机制的研究取得重大进展，减重治疗也逐渐被重视。因此，本文从发病率、共同发病机制、治疗等方面就OSAHS与代谢性疾病的关系及其干预的研究进展作一综述，以期对OSAHS合并代谢性疾病患者的临床精准诊疗有所帮助。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	吴仪伟张珂承孙运帷武攸陈琰

关键词 ：阻塞性睡眠呼吸暂停低通气综合征, 糖尿病, 肥胖, 非酒精性脂肪肝

Abstract：There is bidirectional association between obstructive sleep apnea hypopnea syndrome (OSAHS) and metabolic diseases such as obesity, type 2 diabetes mellitus, and nonalcoholic fatty liver. In recent years, the incidence rate of OSAHS continues to rise, causing serious harm to both physical and mental health of patients. However, in previous studies, the mechanism of action related to OSAHS and metabolic diseases is not clear enough, and the treatment methods of OSAHS combined with metabolic diseases are also relatively limited. In recent years, OSAHS and metabolic diseases become research hotspots. Significant progress is made in the study of their common pathogenesis, and weight loss treatment is also gain attention. Therefore, this paper reviews the latest advances in the relationship between OSAHS and metabolic diseases and their intervention, from the aspects of incidence rate, common mechanism, treatment and so on, aiming at helping the progress of clinical treatment of metabolic diseases in OSAHS.

Key words： Obstructive sleep apnea hypopnea syndrome Diabetes mellitus Obesity Nonalcoholic fatty liver disease

基金资助:中国博士后科学基金面上项目（2019M651218）。

通讯作者: 陈琰（1982.2-），女，博士，副主任医师，吉林大学第二医院内分泌科秘书；研究方向：肥胖、糖尿病及其并发症的发病机制。

作者简介: 吴仪伟（1997.10-），女，吉林大学2021级内科学专业在读硕士研究生；研究方向：肥胖、非酒精性脂肪性肝病、糖尿病及其并发症。

引用本文:

吴仪伟张珂承孙运帷武攸陈琰. 阻塞性睡眠呼吸暂停低通气综合征与代谢性疾病的研究进展[J]. 中国医药导报, 2023, 20(8): 50-53.
WU Yiwei ZHANG Kecheng SUN Yunwei WU You CHEN Yan. Research progress of obstructive sleep apnea hypopnea syndrome and metabolic diseases. 中国医药导报, 2023, 20(8): 50-53.

链接本文:

https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.08.10 或 https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I8/50

[1] 刘雪.吸烟与阻塞性睡眠呼吸暂停低通气综合征的相关性研究[D].郑州：郑州大学，2020.
[2] Bock JM，Rodysill KJ，Calvin AD，et al. Waist-To-Hip Ratio Predicts Abnormal Overnight Oximetry in Men Independent of Body Mass Index [J]. Front Cardiovasc Med，2021，8：789860.
[3] 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南[J].中华结核和呼吸杂志，2012，35（1）：9-12.
[4] Rajesh S，Wonderling D，Simonds AK，et al. Guideline Committee. Obstructive sleep apnoea/ hypopnoea syndrome and obesity hyperventilation syndrome in over 16s：summary of NICE guidance [J]. BMJ，2022，376：o619.
[5] 李舍予，袁祥，李双庆，等.关注肥胖防控中的睡眠健康[J].中国全科医学，2017，20（11）：1282-1287.
[6] 连鹏，赵弘卿.2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征患者的临床特征分析[J].世界睡眠医学杂志，2020，7（11）：1870-1872.
[7] Zhao L，Liu Y，Wang X. TNF-α promotes insulin resistance in obstructive sleep apnea-hypopnea syndrome [J]. Exp Ther Med，2021，21（6）：568.
[8] 张润，王茂筠，王怡唯，等.肥胖程度及睡眠体位对阻塞性睡眠呼吸暂停低通气综合征患者的影响研究[J].中国全科医学，2017，20（11）：1294－1299．
[9] 郑艳文，邬海燕，胡立红，等.肥胖对OSAHS患者日间嗜睡的影响[J].中外医学研究，2020，18（11）：6-8.
[10] Pamuk AE，Süslü AE，Yal?觭?覦nkaya A，et al. The serum leptin level in non-obese patients with obstructive sleep apnea [J]. Auris Nasus Larynx，2018，45（4）：796-800.
[11] Ciriello J，Moreau JM，Caverson MM，et al. Leptin：A Potential Link Between Obstructive Sleep Apnea and Obesity [J]. Front Physiol，2022，12：767318.
[12] Gabryelska A，Karuga FF，Szmyd B，et al. HIF-1α as a Mediator of Insulin Resistance，T2DM，and Its Complications： Potential Links With Obstructive Sleep Apnea [J]. Front Physiol，2020，11：1035.
[13] Xia QS，Lu FE，Wu F，et al. New role for ceramide in hypoxia and insulin resistance[J].World J Gastroenterol，2020，26（18）：2177-2186.
[14] 魏嘉洁，矫杰，周迎生.2型糖尿病合并阻塞性睡眠呼吸暂停综合征的临床特征及其危险因素[J].首都医科大学学报，2020，41（1）：35-39.
[15] Xue P，Covassin N，Ran X，et al. Association of parameters of nocturnal hypoxemia with diabetic microvascular complications： A cross-sectional study [J]. Diabetes Res Clin Pract，2020，170：108484.
[16] Chiang JF，Sun MH，Chen KJ，et al. Association Between Obstructive Sleep Apnea and Diabetic Macular Edema in Patients with Type 2 Diabetes [J]. Am J Ophthalmol，2021， 226：217-225.
[17] Monda VM，Porcellati F，Strollo F，et al. Possible Preventative/Rehabilitative Role of Gliflozins in OSA and T2DM. A Systematic Literature Review-Based Hypothesis [J]. Adv Ther，2021，38（8）：4195-4214.
[18] Monda VM，Porcellati F，Strollo F，et al. Possible Preventative/Rehabilitative Role of Gliflozins in OSA and T2DM. A Systematic Literature Review-Based Hypothesis [J]. Adv Ther，2021，38（8）：4195-4214.
[19] Jullian-Desayes I，Trzepizur W，Boursier J，et al. Obstructive sleep apnea，chronic obstructive pulmonary disease and NAFLD： an individual participant data meta-analysis [J]. Sleep Med，2021，77：357-364.
[20] Landete P，Fernández-García CE，Aldave-Orzaiz B，et al. Increased Oxygen Desaturation Time During Sleep Is a Risk Factor for NASH in Patients With Obstructive Sleep Apnea：A Prospective Cohort Study [J]. Front Med（Lausanne），2022，9：808417.
[21] Zhang H，Zhou L，Zhou Y，et al. Intermittent hypoxia aggravates non-alcoholic fatty liver disease via RIPK3-dependent necroptosis-modulated Nrf2/NFκB signaling pathway [J]. Life Sci，2021，285：119963.
[22] Bosco G，Morato M，Pérez-Martín N，et al. One-Stage Multilevel Surgery for Treatment of Obstructive Sleep Apnea Syndrome [J]. J Clin Med，2021，10（21）：4822.
[23] 郁文俊，朱华明，许华俊，等. HUPPP联合舌根射频消融术或舌根牵引术治疗中重度OSAHS的疗效对比研究：一项多中心随机对照试验[J].中华耳鼻咽喉头颈外科杂志，2021，56（12）：1248-1255.
[24] National Guideline Centre （UK）. CPAP devices for the treatment of mild OSAHS： Obstructive sleep apnoea/ hypopnoea syndrome and obesity hypoventilation syndrome in over 16s [M]. National Institute for Health and Care Excellence （NICE），2021.
[25] Ishak A，Ramsay M，Hart N，et al. BPAP is an effective second-line therapy for obese patients with OSA failing regular CPAP： A prospective observational cohort study [J]. Respirology，2020，25（4）：443-448.
[26] Sprung VS，Kemp GJ，Wilding JP，et al. Randomised，cOntrolled Multicentre trial of 26 weeks subcutaneous liraglutide （a glucagon-like peptide-1 receptor Agonist），with or without contiNuous positive airway pressure （CPAP），in patients with type 2 diabetes mellitus （T2DM） and obstructive sleep apnoEa （OSA）（ROMANCE）： study protocol assessing the effects of weight loss on the apnea-hypnoea index （AHI）[J]. BMJ Open，2020，10（7）：e038856.
[27] Ng SSS，Wong VWS，Wong GLH，et al. Continuous Positive Airway Pressure Does Not Improve Nonalcoholic Fatty Liver Disease in Patients with Obstructive Sleep Apnea. A Randomized Clinical Trial [J]. Am J Respir Crit Care Med，2021，203（4）：493-501.
[28] Liu K，Liu B，Heilbronn LK. Intermittent fasting： What questions should we be asking? [J]. Physiol Behav，2020， 218：112827.
[29] WHO Guidelines on Physical Activity and Sedentary Behaviour [M]. Geneva：World Health Organization，2020.
[30] Tao L，Wang L，Yang X，et al. Recombinant human glucagon- like peptide-1 protects against chronic intermittent hypoxia by improving myocardial energy metabolism and mitochondrial biogenesis [J]. Mol Cell Endocrinol，2019，481：95-103.
[31] Heerspink HJL，Stefa’nsson BV，Correa-Rotter R，et al. Dapagliflozin in patients with chronic kidney Disease [J]. N Engl J Med，2020，383（15）：1436-1446.
[32] Winslow DH，Bowden CH，DiDonato KP，et al. A randomized，double-blind，placebo-controlled study of an oral，extended-release formulation of phentermine/topiramate for the treatment of obstructive sleep apnoea in obese adults [J]. Sleep，2012，35：1529-1539.
[33] Schmickl CN，Edwards BA，Malhotra A. Drug Therapy for Obstructive Sleep Apnea：Are We There Yet? [J]. Am J Respir Crit Care Med，2022，205（12）：1379-1381.
[34] Zhang YX，Yang L，Yang CC，et al. Correlation between Obstructive Sleep Apnea and Non-Alcoholic Fatty Liver Disease before and after Metabolic Bariatric Surgery [J]. Obes Surg，2020，30（10）：3803-3812.
[35] 中国研究型医院学会糖尿病与肥胖外科专业委员会.减重代谢外科围术期处理专家共识（2019版）[J].中华消化外科杂志，2019，18（9）：811-821.
[36] 杨珵璨，王兵.减重代谢手术治疗肥胖合并阻塞性睡眠呼吸暂停低通气综合征[J].上海医药，2021，42（11）：3-5.