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Chest:OSA与2型糖尿病以及CPAP的治疗效果

2019-06-22 xing.T MedSci原创

由此可见,尽管OSA严重程度可独立预测了糖尿病,但在调整各种基线代谢危险因素和随后的体重变化后,长期接受CPAP治疗与降低T2D风险相关。

OSA与葡萄糖代谢之间的关系仍存在争议。近日,呼吸领域权威杂志chest上发表了一篇研究文章,这项回顾性研究调查了中国香港成人临床队列中OSA与2型糖尿病(T2D)之间的关系,以及长期CPAP治疗的效果。

T2D诊断和CPAP使用的数据来自全港电子卫生管理系统和睡眠诊所CPAP依从性的协议评估记录。研究人员通过Cox回归模型检查基线OSA和T2D之间的关系以及CPAP治疗的效果,并使用三次样条分析评估T2D风险。

在2006年至2013年进行过夜睡眠研究和临床评估的1206名受试者中,152名受试者发生糖尿病(中位随访7.3年)。在完全调整的模型中,未经治疗的中度或严重OSA患者发生糖尿病的风险较高,风险比分别为2.01(95%CI为1.06-3.81)和2.62(95%CI为1.40-4.93),且在那些患有严重OSA的个体中趋于平稳。OSA和肥胖之间没有相互作用。大约三分之一的中重度OSA受试者接受了常规的CPAP治疗,其与糖尿病发病率从3.41人降至1.61人每100人每年相关。

由此可见,尽管OSA严重程度可独立预测了糖尿病,但在调整各种基线代谢危险因素和随后的体重变化后,长期接受CPAP治疗与降低T2D风险相关。

原始出处:

Pei Hang Xu,et al.Incident Type 2 Diabetes in OSA and Effect of CPAP Treatment A Retrospective Clinic Cohort Study.chest.2019.https://doi.org/10.1016/j.chest.2019.04.130

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    2019-09-23 Smile2680
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  5. [GetPortalCommentsPageByObjectIdResponse(id=2051398, encodeId=005d2051398f1, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Sun Oct 27 16:19:00 CST 2019, time=2019-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030170, encodeId=384c20301e0bc, content=<a href='/topic/show?id=d88913e2636' target=_blank style='color:#2F92EE;'>#PAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13726, encryptionId=d88913e2636, topicName=PAP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=82ba2500166, createdName=ms1467340776200723, createdTime=Sat Apr 11 23:19:00 CST 2020, time=2020-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929568, encodeId=90a919295682d, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Mon Sep 23 20:19:00 CST 2019, time=2019-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1894117, encodeId=81b6189411e98, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Sun May 24 09:19:00 CST 2020, time=2020-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331371, encodeId=c46d13313e118, content=<a href='/topic/show?id=1b32515586' target=_blank style='color:#2F92EE;'>#CPAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5155, encryptionId=1b32515586, topicName=CPAP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0802500050, createdName=肉我只吃一口, createdTime=Mon Jun 24 13:19:00 CST 2019, time=2019-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349785, encodeId=7d0a1349e85b4, content=<a href='/topic/show?id=3d0d134904c' target=_blank style='color:#2F92EE;'>#OSA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13490, encryptionId=3d0d134904c, topicName=OSA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Mon Jun 24 13:19:00 CST 2019, time=2019-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032200, encodeId=08a3103220099, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sun Jun 23 01:19:00 CST 2019, time=2019-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042541, encodeId=94b41042541b5, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sun Jun 23 01:19:00 CST 2019, time=2019-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046854, encodeId=67eb104685493, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Jun 23 01:19:00 CST 2019, time=2019-06-23, status=1, ipAttribution=)]
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    2019-06-24 bioon3
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    2019-06-23 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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    2019-06-23 misszhang

    谢谢MedSci提供最新的资讯

    0

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    2019-06-23 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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与12个月以上的常规护理相比,采用CPAP治疗OSA并未改善2型糖尿病合并DMO患者的视力。

Eur Respir J:阻塞性睡眠呼吸暂停是发生代谢综合征的危险因素

由此可见,在一般人群中通过调节夜间低氧血症,OSA与发生MetS风险增加独立相关。

Chest:接受CPAP的高心血管风险OSA患者多模式远程监测效果

由此可见,在具有高心血管风险的OSA患者中,多模式远程监护在改善家庭血压方面并不优于通常的CPAP护理。然而,远程监护改善了依从性和以患者为中心的结果。

JAHA:阻塞性睡眠呼吸暂停与急性冠状动脉综合征患者心血管结局的关系

由此可见,ACS后OSA与1年MACCE之间无独立相关性。仅在随访1年后观察到与OSA相关的风险增加。在ACS后作为二级预防的OSA治疗的疗效需要进一步研究。

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