Abstract:Objective: To explore the clinical value of detecting leptin, hypersensitive c-reactive protein in serum in patients with Impaired glucose tolerance and sleep disorders. Methods: Choose hospitalized patients with no history of diabetes from May 2015 to May 2017.The oral glucose tolerance test (OGTT) was tested to assess blood glucose metabolism and Pittsburgh sleep quality index (PSQI)was evaluated to assess sleep status. 72 IGT patients were selected. According to the PSQI score, IGT patients were divided into IGT+ sleep disorder group and IGT+ non-sleep disorder group. In addition, 58 patients with normal glucose tolerance and no sleep disorder were selected as the control group. HsCRP, leptin and pancreas islet function were measured in each group. Results: The median levels of FPG, 2hPG and 2hIns in the IGT with non-sleep disorder group and the IGT with sleep disorder group were higher than those in the control group (P<0.05); the median level of HbA1c and HOMA-IR in IGT with non-sleep disorder group was higher than that in the control group (P<0.05).The median level of Leptin in the IGT with non-sleep disorder group and the IGT with sleep disorder group was higher than that in the control group (P<0.05);The median level of hsCRP in the IGT with sleep disorder group was higher than that in the IGT with non-sleep disorder group, the median hsCRP of the IGT with non-sleep disorder group was higher than that of the control group (all P <0.05).The median level of PSQI in the IGT with sleep disorder group was higher than in the IGT with non- sleep disorder group and the control group (P<0.05).Logistic regression analysis showed that sleep disorders was positively correlated with 2hPG and hsCRP (P<0.05);Hyperinsulinemia, PSQI and glucose tolerance were positively correlated (P<0.05). Conclusion: Levels of hsCRP and leptin were significantly increased in patients with IGT and sleep disorders, inflammation and leptin play a role in sleep disorders, which may further aggravate insulin resistance and thereby increase the risk of glucose tolerance reduction.
刘敏,王兆鹏,冯玉梅,杨新宏,孙常铭,张萍. 瘦素超敏C反应蛋白在糖耐量减低并睡眠障碍患者中的临床意义[J]. 河北医学, 2018, 24(10): 1672-1676.
LIU Min, WANG Zhaopeng, FENG Yumei, et al. Clinical Significance of Detecting Leptin Hypersensitive C-reactive Protein in Patients with Impaired Glucose Tolerance and Sleep Disorders. HeBei Med, 2018, 24(10): 1672-1676.
[1] Cappuccio FP, D'Elia L, Strazzullo P, et al. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis[J]Diabetes Care, 2010,33(2):414~20. [2] 中华医学会神经病学分会睡眠障碍学组.中国成人失眠诊断与治疗指南[J].中华神经科杂志,2012,45(07):534~540. [3] Koren D, Taveras EM. Association of sleep disturbances with obesity, insulin resistance and the metabolic syndrome[J]Metabolism. 2018, 84:67~75. [4] Buxton O M, Pavlova M, Reid Emily W, et al. Sleep restriction for 1 week reduces insulin sensitivity in healthy men[J]Diabetes,2010,59(9):2126~33. [5] Engeda J, Mezuk B, Ratliff S, et al. Association between duration and quality of sleep and the risk of prediabetes:evidence from NHANES[J]. Diabet Med,2013, 30(6):676~680. [6] Pyykkonen AJ,Isomaa B,Pesonen AK,et al. Subjective sleep complaints are associated with insulin resistance in individuals without diabetes: the PPP-Botnia Study[J]Diabetes Care,2012,35(11):2271~2278. [7] Wright KP, Drake AL, Frey DJ, et al. Influence of sleep deprivation and circadian misalignment on cortisol, inflammatory markers, and cytokine balance[J]Brain Behav Immun, 2015,47:24~34. [8] Chiang JK. Short duration of sleep is associated with elevated high-sensitivity C-reactive protein level in Taiwanese adults: a cross-sectional study[J]Clin Sleep Med,2014,10(7):743~749. [9] 罗蓉,李小平,高兴玉,等.糖耐量减低人群血清C反应蛋白、白介素6、肿瘤坏死因子α及瘦素水平变化及其相关因素研究[J].实用心脑肺血管病杂志,2014,(11):38~40.