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Title: [Association between serum adipocyte fatty acid binding protein level and insulin resistance in patients with OSAS].
Author: Wang YB, Li XF, Chen R, Shen JH, Zhang YH.
Journal: Zhonghua Yi Xue Za Zhi; 2017 Dec 26; 97(48):3779-3782. PubMed ID: 29325335.
Abstract:
Objective: To investigate the association between serum adipocyte fatty acid binding protein (A-FABP) level and insulin resistance in patients with obstructive sleep apnea syndromes (OSAS). Methods: Eighty patients with snoring were monitored by overnight polysomnography (PSG) from September 2015 to July 2017, and there were 59 males and 21 females, aged from 22 to 77 years old (mean age 47±14 years old). Based on the apnea-hypopnea index (AHI), these patients were divided into three groups: primary snoring group (AHI<5/h, n=19), mild-moderate OSAS groups (5/h≤AHI≤30/h, n=23) and severe OSAS groups (AHI>30/h, n=38). The levels of A-FABP, the fasting plasma glucose (FPG), fasting insulin (FINS) and insulin resistance index (IRI) were compared between the primary snoring group and OSAS patients with different severities, and the correlations between serum A-FABP and IRI as well as PSG parameters were further evaluated using partial correlation analysis. Results: Compared with the primary snoring group [(15.6±3.5) μg/L] and mild-moderate group [(17.4±4.3) μg/L], there was a significant increase of the serum A-FABP level in the severe OSAS group [(21.4±4.6) μg/L](P=0.001, P=0.025). Additionally, after adjustment for BMI and age, serum A-FABP level showed significant positive correlations with FINS and IRI (r=0.478, P<0.001; r=0.356, P=0.035); serum A-FABP level was positively correlated with AHI and the arterial oxygen saturation (SaO(2)) < 90% time ratio in night (TS90%) (r=0.251, P=0.041 and r=0.271, P=0.035). Nevertheless, serum A-FABP level showed significant negative correlation with the lowest SaO(2) and the mean SaO(2) (r=-0.244, P=0.038 and r=-0.280, P=0.018). Conclusion: Insulin resistance and the increased level of serum A-FABP are common in OSAS patients, the level of serum A-FABP is significantly correlated with insulin resistance and nocturnal intermittent hypoxia, both of which suggest that A-FABP plays a potential role in insulin resistance in patients with OSAS. 目的： 探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者血清中脂肪型脂肪酸结合蛋白(A－FABP)水平及其与胰岛素抵抗的关系。 方法： 收集2015年9月至2017年7月因打鼾行多导睡眠监测的患者80例，其中男59例，女21例；年龄(47±14)岁。按呼吸暂停低通气指数(AHI)将患者分为3组：单纯鼾症组(AHI<5/h)19例，轻中度OSAS组(5次/h≤AHI≤30次/h)23例，重度OSAS组(AHI>30次/h)38例。比较各组空腹血A－FABP及空腹血糖、空腹胰岛素(FINS)、胰岛素抵抗指数(IRI)的差异，分析A－FABP与IRI和睡眠呼吸参数的相关性。 结果： 重度OSAS组血清A－FABP水平为(21.4±4.6)μg/L，明显高于单纯鼾症组的(15.6±3.5)μg/L和轻中度OSAS组的(17.4±4.3)μg/L(P＝0.001和P＝0.025)。经校正年龄、体质指数之后，血清A－FABP与FINS、IRI水平呈正相关(r＝0.478，P<0.001和r＝0.356，P＝0.035)；血清A－FABP水平与睡眠呼吸暂停低通气指数和夜间动脉血氧饱和度(SaO(2))<90%时间比率(TS90%)呈正相关(r＝0.251，P＝0.041和r＝0.271，P＝0.035)，与最低SaO(2)和平均SaO(2)呈负相关(r＝－0.244，P＝0.038和r＝－0.280，P＝0.018)。 结论： OSAS患者存在胰岛素抵抗及血清A－FABP水平的增高，血清A－FABP水平与胰岛素抵抗及夜间间歇低氧相关，提示血清A－FABP可能参与OSAS患者胰岛素抵抗的发生。.

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