JCEM:糖尿病视网膜病变的2型糖尿病患者快速动眼睡眠期间呼吸暂停低通气指数

2019-01-12 xing.T MedSci原创

由此可见,REM-AHI与DR独立相关。REM-AHI可能是DR的潜在危险因素。

最近基于家庭睡眠呼吸暂停测试(HSAT)的研究报告了睡眠呼吸障碍(SDB)(如阻塞性睡眠呼吸暂停(OSA))与糖尿病视网膜病变(DR)之间潜在的关联。一些研究表明,快速动眼睡眠期间的呼吸暂停低通气指数(REM-AHI)与糖化血红蛋白和高血压相关,这是DR两个已知的危险因素。然而,没有研究评估REM-AHI与DR之间的关联,因为之前的研究都是基于HSAT。

近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在确定REM-AHI与DR之间的关联。该研究的受试者为131名2型糖尿病患者,他们进行了夜间多导睡眠监测,睡眠时间≥30分钟且没有心力衰竭或活动性肺病,尚未接受过OSA治疗。研究人员进行Logistic回归分析以确定REM-AHI对DR患病率的影响,调整了几种DR已知的危险因素。

REM-AHI的四分位数与DR独立相关[p=0.024,Q2比值比(OR)和95%置信区间(95%CI)为3.887(0.737-20.495); Q3为9.467(1.883-47.588); Q4为12.898(2.008-82.823),相比于Q1,而NREM-AHI的四分位数则不然(p=0.119)。类似地,连续REM-AHI(OR为2.875; 95%CI为1.224-6.752; p=0.015)与DR独立相关,而NREM-AHI则不是(p=0.107)。此外,当控制几种已知的DR风险因素时,AHI与DR独立相关(p=0.043)。

由此可见,REM-AHI与DR独立相关。REM-AHI可能是DR的潜在危险因素。

原始出处:

Akihiro Nishimura,et al.Apnea hypopnea index during rapid eye movement sleep with diabetic retinopathy in patients with type 2 diabetes.J Clin Endocrinol Metab. 2019.https://doi.org/10.1210/jc.2018-00946

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time=2019-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042196, encodeId=9d161042196bb, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Jan 12 16:31:00 CST 2019, time=2019-01-12, status=1, ipAttribution=)]
    2019-08-25 achengzhao
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    2019-01-20 smallant2015
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    2019-01-15 wxl882001

    了解一下

    0

  4. 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href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Mon Jan 14 04:31:00 CST 2019, time=2019-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=357929, encodeId=930735e92901, content=好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Sat Jan 12 16:52:31 CST 2019, time=2019-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042196, encodeId=9d161042196bb, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Jan 12 16:31:00 CST 2019, time=2019-01-12, status=1, ipAttribution=)]
    2019-01-14 zutt
  5. 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  6. 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  7. 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  9. 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time=2019-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042196, encodeId=9d161042196bb, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Jan 12 16:31:00 CST 2019, time=2019-01-12, status=1, ipAttribution=)]
    2019-01-12 lietome2

    好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。

    0

  10. 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time=2019-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042196, encodeId=9d161042196bb, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Jan 12 16:31:00 CST 2019, time=2019-01-12, status=1, ipAttribution=)]
    2019-01-12 misszhang

    谢谢MedSci提供最新的资讯

    0

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由此可见,当前的证据表明T2DM患者服用DPP-4i、GLP-1RA或SGLT2抑制剂与DR风险之间的相关性尚不能确定。一些证据表明磺脲类药物可能与DR风险增加相关,鉴于对DR事件并未进行系统的评估,这些效应需要在大型精心设计的研究中进行进一步的探索。

Diabetes Obes Metab:糖尿病视网膜病变与其它糖尿病并发症之间的关系

由此可见,该分析强调了对患者管理采取协调和协作方法的必要性。鉴于可以在眼科诊室外广泛进行DR筛查计划,以及DR筛查的总体成本效益,DR的存在和严重程度可以作为识别微血管和大血管并发症风险增加患者的筛查手段,能够早期发现、转诊和干预,目的是降低糖尿病患者的发病率和死亡率。参与糖尿病管理的医疗保健专业人员应鼓励患者定期进行DR筛查。

JCEM:糖尿病视网膜病变与帕金森病之间的关系

由此可见,并发DR与PD发生风险增加有关。进一步研究调查DR患者PD发生风险增加的机制是很有必要,包括CNS中的多巴胺缺乏和长期不良的血糖控制。

Diabetes Care:估计的静息代谢率和身体成分指标与2型糖尿病患者的糖尿病视网膜病变密切相关

由此可见,在本研究中,RMR和身体成分指标与DR和严重程度密切相关。这些发现如果得到证实,表明RMR和身体成分可能是DR病理生理学中实际代谢状态的较强标志物。