[1]刘丹,吴润华,陈乃洁,等.阻塞性睡眠呼吸暂停低通气综合征患者胰岛素抵抗发生机制及治疗研究进展[J].新乡医学院学报,2023,40(10):986-990.[doi:10.7683/xxyxyxb.2023.10.015]
　LIU Dan,WU Runhua,CHEN Naijie,et al.Research progress of the pathogenesis and treatment of insulin resistance in patients with obstructive sleep apnea hypopnea syndrome[J].Journal of Xinxiang Medical University,2023,40(10):986-990.[doi:10.7683/xxyxyxb.2023.10.015]
点击复制

阻塞性睡眠呼吸暂停低通气综合征患者胰岛素抵抗发生机制及治疗研究进展
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年10
页码:
986-990
栏目:
综述
出版日期:
2023-10-05

文章信息/Info

Title:
Research progress of the pathogenesis and treatment of insulin resistance in patients with obstructive sleep apnea hypopnea syndrome
作者:
刘丹1; 吴润华1; 陈乃洁1; 李璟怡1; 魏敏1; 陈沁2
（1.福建中医药大学中西医结合学院，福建　福州　350122；2.福建中医药大学临床技能教学中心，福建　福州　350122）
Author(s):
LIU Dan1; WU Runhua1; CHEN Naijie1 ; LI Jingyi1; WEI Min1; CHEN Qin2
（1.College of Integrative Medicine,Fujian University of Traditional Chinese Medicine，Fuzhou 350122,Fujian Province，China；2.Clinical Energy Teaching Center Fujian University of Chinese Medicine，Fuzhou 350122,Fujian Province，China）
关键词:
阻塞性睡眠呼吸暂停低通气综合征; 胰岛素抵抗; 糖耐量减低; 糖尿病
Keywords:
obstructive sleep apnea hypopnea syndrome; insulin resistance; glucose tolerance; diabetes mellitus
分类号:
R563
DOI:
10.7683/xxyxyxb.2023.10.015
文献标志码:
A
摘要:
阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是一种常见的慢性疾病，近年来其与2型糖尿病的关系被很多学者关注。胰岛素抵抗是将T2DM与OSAHS联系起来的关键因素。OSAHS的慢性间歇性缺氧和睡眠碎片化激活交感神经系统和下丘脑-垂体-肾上腺轴，引起全身炎症和自噬等，促进胰岛素抵抗的发展，进展为葡萄糖耐量减低，并最终导致T2DM。但OSAHS和胰岛素抵抗之间的具体通路尚不明确，需要进一步研究来验证。本文针对OSAHS患者胰岛素抵抗的发生机制以及治疗措施方面的研究进展做一综述，以期为OSAHS患者胰岛素抵抗的临床和基础研究提供参考。
Abstract:
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common chronic disease.In recent years,the correlation of OSAHS with type 2 diabetes has attracted many scholars′ attention.Insulin resistance is the key factor linking T2DM with OSAHS.Chronic intermittent hypoxia and sleep fragmentation of OSAHS activate the sympathetic nervous system,and hypothalamic-pituitary-adrenal axis,which cause systemic inflammation and autophagy,promote the development of insulin resistance and progress to reduced glucose tolerance,eventually leading to T2DM.However,the evidence on the specific pathway between OSAHS and insulin resistance is insufficient,and further studies are needed to verify it.This article will makes a review on the new research progress in the pathogenesis and treatment of insulin resistance in patients with OSAHS,in order to provide reference for clinical and basic research.

参考文献/References:

［1］　OGURTSOVA K,FERNANDES J D,HUANG Y,et al.IDF Diabetes Atlas:global estimates for the prevalence of diabetes for 2015 and 2040［J］.Diabetes Res Clin Pract,2017,128:40-50.
［2］　HILL E A,WILLAMS L J,COOPER S A,et al.Objective and subjective prevalence of obstructive sleep apnoea/hypopnoea syndrome in UK adults with down syndrome:a strong marker for diurnal behavioural disturbances［J］.Brain Sci,2021,11(9):1160.
［3］　ISOBE Y,NAKATSUMI Y,SUGIYAMA Y,et al.Severity indices for obstructive sleep apnea syndrome reflecting glycemic control or insulin resistance［J］.Intern Med,2019,58(22):3227-3234.
［4］　ANDRADE C M,PATEL B,VELLANKI M,et al.Safety of gastrointestinal endoscopy with conscious sedation in obstructive sleep apnea［J］.World J Gastrointest Endosc,2017,9:552-557.
［5］　HIROTSU C,HABA-RUBIO J,TOGEIRO S M,et al.Obstructive sleep apnoea as a risk factor for incident metabolic syndrome:a joined Episono and HypnoLaus prospective cohorts study［J］.Eur Respir J,2018,52(5):1801150.
［6］　LI X Y,HUANG H Y,XU H J,et al.Excessive daytime sleepiness,metabolic syndrome,and obstructive sleep apnea:two independent large cross-sectional studies and one interventional study［J］.Respir Res,2019,20(1):276.
［7］　QIAN Y J，XU H J，WANG Y Y，et al.Obstructive sleep apnea predicts risk of metabolic syndrome independently of obesity:a meta-analysis［J］.Arch Med Sci,2016,12(5):1077-1087.
［8］　WANG F,XIONG X L,XU H J,et al.The association between obstructive sleep apnea syndrome and metabolic syndrome:a confirmatory factor analysis［J］.Sleep Breath,2019,23(3):1011-1019.
［9］　GABRYELSKA A，SZMYD B， SZEMRAJ J，et al.Patients with obstructive sleep apnea present with chronic upregulation of serum HIF-1α［J］.J Clin Sleep Med,2020,16(10):1761-1768.
［10］　GAINES J,VGONTZAS A N,FERNANDEZ-MENDOZA J,et al.Increased inflammation from childhood to adolescence predicts sleep apnea in boys:a preliminary study［J］.Brain Behav Immun,2017,64:259-265.
［11］　FU C,JIANG L,ZHU F,et al.Chronic intermittent hypoxia leads to insulin resistance and impaired glucose tolerance through dysregulation of adipokines in non-obese rats［J］.Sleep Breath,2015,19(4):1467-1473.
［12］　HUANG X,HUANG X,GUO H,et al.Intermittent hypoxia-induced METTL3 downregulation facilitates MGLL-mediated lipolysis of adipocytes in OSAS［J］.Cell Death Discov,2022,8(1):352.
［13］　GHARIB S A,HURLEY A L,ROSENO M J,et al.Obstructive sleep apnea and CPAP therapy alter distinct transcriptional programs in subcutaneous fat tissue［J］.Sleep,2020,43(6):zsz314.
［14］　OLAITHE M,BUCKS R S,HILLMAN D R,et al.Cognitive deficits in obstructive sleep apnea:insights from a meta-review and comparison with deficits observed in COPD,insomnia,and sleep deprivation［J］.Sleep Med Rev,2018,38:39-49.
［15］　JASEJAA H,GOYAL M,MISHRA P.Drug-resistant epilepsy and obstructive sleep apnea:exploring a link between the two［J］.World Neurosurgery,2021,146:210-214.
［16］　BAMBHROLIYA Z,SANDRUGU J,LOWE M,et al.Diabetes,polycystic ovarian syndrome,obstructive sleep apnea,and obesity:a systematic review and important emerging themes［J］.Cureus,2022,14(6):e26325.
［17］　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.
［18］　KACZMARSKI P,KARUGA FF,SZMYD B,et al.The role of inflammation,hypoxia,and opioid receptor expression in pain modulation in patients suffering from obstructive sleep apnea［J］.Int J Mol Sci,2022,23(16):9080.
［19］　WANG W,ZHENG Y,LI M,et al.Recent advances in studies on the role of neuroendocrine disorders in obstructive sleep apnea-hypopnea syndrome-related atherosclerosis［J］.Nat Sci Sleep,2021,13:1331-1345.
［20］　TAYLOR K S,MILLAR P J,MURAI H,et al.Cortical autonomic network gray matter and sympathetic nerve activity in obstructive sleep apnea［J］.Sleep,2018,41(2):208.
［21］　ALOMRI R M,KENNEDY G A,WALI S O,et al.Association between nocturnal activity of the sympathetic nervous system and cognitive dysfunction in obstructive sleep apnoea［J］.Sci Rep,2021,11(1):11990.
［22］　SEQUEIRA V C C,BANDEIRA P M，AZEVEDO J C M.Heart rate variability in adults with obstructive sleep apnea:a systematic review［J］.Sleep Sci,2019,12(3):214-221.
［23］　GAN L,LI N,HEIZHATI M,et al.Diurnal cortisol features with type 2 diabetes in patients with hypertension and obstructive sleep apnea:a cohort study［J］.Clin Endocrinol Metab,2023,108(9):e679-e686.
［24］　BUBLITZ M H,MONTEIRO J F,CARAGANIS A,et al.Obstructive sleep apnea in gestational diabetes:a pilot study of the role of the hypothalamic-pituitary-adrenal axis［J］.J Clin Sleep Med,2018,14(1):87-93.
［25］　ZHAO Y M,TAN W,FEI Y Q,et al.The causal relationships between obstructive sleep apnea and elevated CRP and TNF-α protein levels［J］.Ann Med,2022,54(1):1578-1589.
［26］　YI M,ZHAO W,FEI Q,et al.Causal analysis between altered levels of interleukins and obstructive sleep apnea［J］.Front Immunol,2022,13:888644.
［27］　BHATT S P,GULERIA R,KABRA S K.Metabolic alterations and systemic inflammation in overweight/obese children with obstructive sleep apnea［J］.PLoS One,2021,16(6):e0252353.
［28］　MANIACI A,IANNELAA G,COCUZZA S,et al.Oxidative stress and inflammation biomarker expression in obstructive sleep apnea patients［J］.J Clin Med,2021,10(2):277.
［29］　UNNIKRISHNAN D,JUN J,POLOTSKY V.Inflammation in sleep apnea:an update［J］.Rev Endocr Metab Disord,2015,16(1):25-34.
［30］　SEIFEN C,PORDZIK J,HUPPERTZ T,et al.Serum ferritin levels in severe obstructive sleep apnea［J］.Diagnostics(Basel),2023,13(6):1154.
［31］　CHEN Y C,LIN I C,SU M C,et al.Autophagy impairment in patients with obstructive sleep apnea modulates intermittent hypoxia-induced oxidative stress and cell apoptosis via hypermethylation of the ATG5 gene promoter region［J］.Eur J Med Res,2023,28(1):82.
［32］　GUO Q,XU L,LI H,et al.Progranulin causes adipose insulin resistance via increased autophagy resulting from activated oxidative stress and endoplas micreticulum stress［J］.Lipids Health Dis,2017,16 (1):25-31.
［33］　DING H,GUO H,CAO J.The importance of autophagy regulation in obstructive sleep apnea［J］.Sleep Breath,2021,25(3):1211-1218.
［34］　ARNAUDD C,BOCHATON T,PEPIN J L,et al.Obstructive sleep apnoea and cardiovascular consequences:pathophysiological mechanisms［J］.Arch Cardiovasc Dis,2020,113(5):350-358.
［35］　GUO X,SHI Y,DU P,et al.HMGB1/TLR4 promotes apoptosis and reduces autophagy of hippocampal neurons in diabetes combined with OSA［J］.Life Sci,2019,239:117020.
［36］　POZA J J,PUJOL M,ORTEGA-ALBS J J,et al.Melatonin in sleep disorders［J］.Neurologia(Engl Ed),2022,37(7):575-585.
［37］　LIMBERARR N,PHAM J,BUDHIRAJA R,et al.NREM parasomnias:retrospective analysis of treatment approaches and comorbidities［J］.Clocks Sleep,2022,4(3):374-380.
［38］　MONDA V M,GENTILE S,PORCELLATI F,et al.Heart failure with preserved ejection fraction and obstructive sleep apnea:a novel paradigm for additional cardiovascular benefit of SGLT2 inhibitors in subjects with or without type 2 diabetes［J］.Adv Ther,2022,39(11):4837-4846.
［39］　GNONI V,ILIC K,DRAKATOS P,et al.Obstructive sleep apnea and multiple facets of a neuroinflammatory response:a narrative review［J］.J Thorac Dis,2022,14(2):564-574.
［40］　PASCHOU S A,BLETSAA E,SALTIKI K,et al.Sleep apnea and cardiovascular risk in patients with prediabetes and type 2 diabetes［J］.Nutrients,2022,14(23):4989.
［41］　ZOU J,LIU Y,XU H,et al.Association of apnea-hypopnea index during rapid eye movement sleep with insulin resistance in patients with suspected obstructive sleep apnea:a cross-sectional study［J］.Ann Transl Med,2021,9(3):243.
［42］　GEORGOULISM,YIANNKOURS N,KECHRIBARI I,et al.Cardiometabolic benefits of a weight-loss mediterranean diet/lifestyle intervention in patients with obstructive sleep apnea:the “mimosa” randomized clinical trial［J］.Nutrients,2020,12(6):1570.
［43］　WILCKENS K A,JEON B,MORRIS J L,et al.Effects of continuous positive airway pressure treatment on sleep architecture in adults with obstructive sleep apnea and type 2 diabetes［J］.Front Hum Neurosci,2022,16:924069.
［44］　HUI D S C,NG S S S,WONG G L H,et al.Obstructive sleep apnoea and continuous positive airway pressure therapy for patients with non-alcoholic fatty liver disease:abridged secondary publication［J］.Hong Kong Med J,2022,28(Suppl 1):42-45.
［45］　LABARCA G,SCHMIDT A,DREYSE J,et al.Efficacy of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) and resistant hypertension (RH):systematic review and meta-analysis［J］.Sleep Med Rev,2021,58:101446.
［46］　NG S S S,WONG V W S,WONG G L H,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.

相似文献/References:

[1]李怀祥,校庆志,王保琴,等.胰岛素抵抗与高血压病冠心病糖尿病[J].新乡医学院学报,1996,13(02):116.
[2]宋晓敏　杨　冰　杜　玮　郭长磊　李根旺　邬玉芳　郭丽萍.豆番粉与玉米粉对人体血糖胰岛素胰升血糖素的影响[J].新乡医学院学报,1998,15(03):234.
[3]秦海梅,杜玮,徐青.Graves病患者糖代谢紊乱60例临床观察[J].新乡医学院学报,2001,18(02):132.
[4]型糖尿病合并高血压的胰岛素敏感性探讨.2型糖尿病合并高血压的胰岛素敏感性探讨[J].新乡医学院学报,2003,20(02):124.
[5]秦海梅,杜　玮,徐　青.2 型糖尿病合并高血压的胰岛素敏感性探讨[J].新乡医学院学报,2003,20(02):124.
[6]乔汉臣.非酒精性脂肪肝病研究进展[J].新乡医学院学报,2006,23(06):630.
[7]董彦玲,来俊英.阻塞性睡眠呼吸暂停低通气综合征的围手术期护理[J].新乡医学院学报,2008,25(02):208.
[8]张 强,朱榕峰,刘 爽,等.高脂诱导非酒精性脂肪性肝病小鼠肝脏Chemerin及其受体的表达[J].新乡医学院学报,2009,26(03):224.
　ZHANG Qiang,ZHU Rong-feng,LIU Shuang,et al.Expression of Chemerin and it′s receptor in liver of mouse with nonalcoholic fatty liver disease induced by high fat diet[J].Journal of Xinxiang Medical University,2009,26(10):224.
[9]田莉娜.2型糖尿病伴非酒精性脂肪肝相关因素分析[J].新乡医学院学报,2010,27(04):394.
[10]殷波.低温等离子射频消融术治疗阻塞性睡眠呼吸暂停低通气综合征[J].新乡医学院学报,2011,28(01):084.

更新日期/Last Update: 2023-10-05