| Objective Obstructive Sleep Apnea Hypopnea syndrom is a clinical common diseases which damage to people health and reduce the quality of life,even threatening people's life.Often accompanied by insulin resistance,the sympathetic nervous excitement,oxidative stress and chronic inflammation.OSAHS is a common complication with obesity,type 2 diabetes,metabolic syndrome.Studies have found that in patients with type 2 diabetes,the prevalence of OSAHS increases year by year,correcting the night ventilation can improve insulin resistance,reduce the sympathetic nervous excitement,lower blood pressure.At present,the polysomnography is the gold standard in the diagnosis of OSAHS,but its price is expensive,poor compliance.So for the selection of measurement used screening and diagnosis of OSAHS has a simple and feasible clinical guiding significance.In this paper,by measuring the type 2 diabetic patients with snoring with neck circumference,neck length,body fat composition,analyzing relevance with Apnea Hyponea Index.Method To choose patients who were treated in our hospital on endocrinology department between January 2015 and September 2016,there are 130 cases of type 2 diabetes and sleep snoring.To measure the neck circumference,neck length,body fat composition such as index,and using PSG to measure the indicators such as Apnea Hyponea Index,oxygen desaturation index and the lowest oxygen saturation.Divided into non-OSAHS,light,medium and heavy four groups(< 5,5~<15,15~<30,?30)accord to AHI.To analysis the correlation between BMI,waist circumference,hip circumference,neck circumference,neck length,body fat composition and AHI,Logistic regression analysis was carried out on the various indicators.Results Compared with the DM with non-OSAHS group,there are no statistical difference in fasting blood glucose ? blood pressure,blood lipid,serum uric between two groups(P>0.05);the neck circumference was higher in DM with OSAHS group(t=2.185,P=2.185),and adjusted the height of neck circumference is statistically significant(t=-2.705,P<0.05);Divided into four groups according to AHI,we find that the severity of OSAHS have statistical significance(P<0.05)in BMI,neck circumference,neck length.In men,visceral fat index,body fat rate,subcutaneous fat index has relations with the severity of OSAHS.There is statistical difference(P<0.05),while in women is no statistical difference(P>0.05).According to the receiver operating characteristic curve,the optimal cut-point of neck circumference for diagnosing OSAHS was 41.2cm with sensitivity of56.9%,specificity of 70%,and area under the Curve of 0.646(95%CI 0.564~0.727).the optimal cut-point of neck length for diagnosing OSAHS was 6.5cm with a sensitivity and specificity of 62.5% and 70%,and area under the Curve of 0.606(95%CI 0.529 ~0.683).Logistic regression analysis showed that neck circumference and neck length are risk indicators of OSAHS(P < 0.05,OR = 3.905),(P < 0.05,OR = 4.841).Conclusion Neck circumference and neck length are independent risk factors for the development of OSAHS with type 2 diabetes,Distinguish between gender and found in the male,neck length is the independent risk factor,the longer the neck length,more serious of OSAHS;In women,neck circumference is the independent risk factors,the thicker of neck circumference,more serious of OSAHS.In this article,through analysis it is screening the best point of neck circumference and neck length in OSAHS patients in this work,this finding provides aid for screening of OSAHS in clinical work.Meaning In this article,through analysis of type 2 diabetic patients with obstructive sleep apnea syndrome neck circumference,neck length and body fat composition and AHI,found that neck circumference,neck length with sleep apnea.Finding the best point of neck circumference and neck length for diagnosing OSAHS,this finding provides aid for screening of OSAHS in clinical work. |
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