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코골이 환자에서 수면무호흡 정도와 인슐린 저항성, 아디포넥틴 및 visfatin과의 관련성

Relationship between AHI and Insulin Resistance, Serum Adiponectin, and Visfatin

대한비만학회지 2008년 17권 2호 p.65 ~ 72
서영성, 안병훈, 조용원, 황상희,
소속 상세정보
서영성 ( Suh Young-Sung ) - 계명대학교 의과대학 가정의학교실
안병훈 ( Ahn Byung-Hoon ) - 계명대학교 의과대학 이비인후과학교실
조용원 ( Cho Yong-Won ) - 계명대학교 의과대학 신경과학교실
황상희 ( Hwang Sang-Hee ) - 계명대학교 의과대학 치과학교실

Abstract


Background: Obstructive sleep apnea (OSA) is closely related to insulin resistance. Adipocytokines, adiponectin and visfatin, may induce the development of insulin resistance among OSA patients. Therefore, we examined the relationships between apnea-hypopnea index (AHI) and insulin resistance; between AHI and adiponectin; and between AHI and visfatin in Korean snoring subjects.

Methods: Eighty one adult habitual snorers who visited the hospital for an examination of polysomnography were divided into either simple snorers (AHI < 5), mild OSA subjects(AHI 5 < or = to < 15), or moderate and severe OSA subjects (AHI > or = 15). Anthropometric data were measured. The serum adiponectin, visfatin, and insulin were measured. Insulin resistance was measured as homeostasis model assessment (HOMA-IR).

Results: After adjusting for age, sex and waist circumference (WC), insulin, HOMA-IR, and adipocytokines were not different among the subgroups. Fasting insulin level and HOMA-IR were positively correlated with body mass index (BMI), WC, hip circumference (HC) and AHI. In addition, HOMA-IR was positively correlated with age. The serum adiponectin level was inversely associated with WC and AHI but positively associated with sex. The serum level of visfatin was negatively correlated with sex. Stepwise multiple regression analysis indicated that WC was an independent variable of fasting insulin (Adj R2 = 0.340) and HOMA-IR (Adj R2 = 0.322) also WC and sex were independent determinants of adiponectin level (Adj R2 = 0.161). Sex was shown to be a predictor of visfatin level (Adj R2 = 0.039).

Conclusion: Waist circumference was found to be independently associated with insulin resistance among the snoring subjects. However, AHI did not serve as a predictor of adiponectin and visfatin

키워드

코골이;수면 무호흡 정도;인슐린 저항성;아디포넥틴
AHI;Snoring;Insulin resistance;Vesfatin;Adiponectin

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