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目的:探讨OSAHS伴胰岛素抵抗(IR)患者术后脂肪因子水平的改变与临床意义。方法:连续性纳入2015-01-2016-08期间就诊的84例OSAHS患者,根据IR情况分为IR组(52例)和非IR组(32例)。所有患者接受悬雍垂腭咽成形术(UPPP),并分别于术前、术后1周和3个月检测chemerin、visfatin和obestatin 3种脂肪因子的水平。结果:IR组患者术前chemerin、visfatin和稳态模型胰岛素抵抗指数(HOMA-IR)水平明显高于非IR组(P<0.05),而obestatin水平明显低于非IR组(P<0.05)。术后1周时IR组obestatin水平明显低于非IR组(P<0.05),HOMA-IR明显高于非IR组(P<0.05)。组内比较可见术后1周IR组患者chemerin、visfatin和HOMA-IR明显下降(P<0.05),obestitin明显上升(P<0.05)。UPPP术与△chemerin(r=-0.685,P<0.05)和△HOMA-IR(r=-0.622,P<0.05)呈负相关,与△obestitin呈正相关(r=0.612,P<0.05)。△HOMA-IR与△chemerin呈正相关(r=0.634,P<0.05)。结论:OSAHS患者经过手术治疗后,chemerin、visfatin和obestatin的水平和IR均明显改善,其中chemerin与IR改善情况最为相关。
Objective: To investigate the changes and clinical significance of postoperative adipokines in OSAHS patients with insulin resistance (IR). Methods: Eighty - four OSAHS patients were enrolled in the study from January 2015 to June 2016. The patients were divided into two groups: IR group (52 cases) and non - IR group (32 cases). All patients underwent uvulopalatopharyngoplasty (UPPP). Levels of three adipokines, chemerin, visfatin and obestatin, were measured preoperatively, 1 week and 3 months after surgery. Results: The preoperative levels of chemerin, visfatin and homeostasis model insulin resistance index (HOMA-IR) in IR group were significantly higher than those in non-IR group (P <0.05), while the levels of obestatin were significantly lower than those in non-IR group (P <0.05). The level of obestatin in IR group was significantly lower than that in non-IR group (P <0.05), HOMA-IR was significantly higher than that in non-IR group (P <0.05). The levels of chemerin, visfatin and HOMA-IR in IR group decreased significantly (P <0.05) and obestitin increased significantly (P <0.05) in the first week after operation. UPPP was negatively correlated with △ chemerin (r = -0.685, P <0.05) and △ HOMA-IR (r = -0.622, P <0.05), and positively correlated with △ obestitin (r = 0.612, P <0.05). △ HOMA-IR and △ chemerin were positively correlated (r = 0.634, P <0.05). Conclusions: The levels of chemerin, visfatin and obestatin and IR in OSAHS patients are significantly improved after surgery. Among them, chemerin is most closely related to the improvement of IR.