关键词: 睡眠呼吸暂停低通气综合征, 阻塞性, 糖尿病, 2型, 骨代谢, 骨密度

Abstract: Objective  To explore the effect of male obstructive sleep apnea hypopnea syndrome (OSAHS) on blood glucose,  bone metabolism and bone mineral density(BMD) in patients with type 2 diabetes mellitus (T2DM). Methods  Male patients with T2DM  admitted to Gansu Provincial People's Hospital from May 2016 to April 2019 were collected.  The patients were divided into simple diabetes group (control group),  T2DM with  mild OSAHS group (mild group)  and T2DM with moderate severe OSAHS (severe group) according to Apnea Hypoventilation Index（AHI）  by polysomnography（PSG） monitor. Calcium (Ca),  phosphorus (P),  vitamin D (VitD),  osteocalcin (OSTE) and beta crosslaps (βCTX)  were detected, average blood glucose level (MBG),  and glycosylated protein (HbA1c) were tested. The  bone mineral density (BMD) of lumbar spine (L14) and left  femur (LF) were measured by US dual energy Xray absorptiometry. The MBG and indexes of bone metabolism and BMD were compared,  and the correlation between AHI and the above indexes were analyzed. Results   There were no significant differences in P,  OSTE,  βCTX,  and L14 BMD among three groups (P>0.05). Compared with control group,  MBG and HbA1c of  mild and severe groups  increased.  While VitD,  Ca and LF BMD decreased (P<0.05). The difference in VitD, Ca, MBG and HbA1c between severe group and mild group were statistically significant (P<0.05).  AHI was positively correlated with BMI,  MBG,  and βCTX in patients with OSAHS and T2DM (r=0.607,  0.208, 0.169; P=0.000,  0.014,  0.046); it was negatively correlated with VitD (r=-0.276,  P=0.001). Conclusion  OSAHS may further aggravate  glucose metabolism and bone metabolism disorder inT2DM patients,  and it will gradually increase with the progress of OSAHS.

Key words: sleep , apnea hypopnea syndrome, obstructive, diabetes mellitus,type 2, bone metabolism, bone mineral density