| Objective To analyze the effects of OSAS on glucose metabolic disorders in hypertensive patients,and to follow up the relationship between hypertensive patients with obstructive sleep apnea syndrome(OSAS)and glucose metabolism,so as to timely intervene in the treatment of OSAS in the future and prevent the occurrence of glucose metabolic disorders in hypertensive patients with OSAS.Method Patients with hypertension who visited the hypertension department of our hospital from January to December 2010 were selected,for patients with possible obstructive sleep apnea syndrome(OSAS)were monitored for night polysomnography(PSG)after medical history and physical examination,we obtained 895 hypertensive patients with first PSG,hypertensive patients(71%)with OSAS,259 cases(29%)of patients without OSAS who were not diagnosed with OSAS and hypoxemia.All patients with diabetes and other nonconformities were excluded from the 895 cases by exclusion criteria.Second medical records and telephone follow-up were made,complete follow-up data were obtained in 2017.Finally,491 cases were obtained,among them,349 patients with hypertension combined with OSAS were divided into mild,moderate and severe groups according to different AHI,and 142 patients with hypertension without OSAS.Follow-up included age,gender,FBG,HbA1 c,etc.,with an average follow-up time of4.45±2.42 years.To analyze the incidence of diabetes and glucose metabolic disorders inpatients with hypertension and OSAS,differences in fasting blood glucose and HbA1 c were observed in patients with hypertension with different severity of OSAS.Result 1.Follow-up at the end of a total of 491 cases of hypertension in patients with combined OSAS patient 349 cases,276 cases of male,female 73 cases,the average follow-up period(4.3± 4.3)years,on average age(51.3±51.3),fasting plasma glucose(5.43 ±1.65)mmol/L,glycosylated hemoglobin(5.91 ±0.83)% patients hypertension without OSAS 142 cases,91 cases of male and female 51 cases,average follow-up time(4.8 ±4.8)years,the average age of follow-up(47.8 ±47.8)years of age,fasting plasma glucose(5.13±0.92)mmol/L,glycosylated hemoglobin(5.6± 0.5)% hypertension combined OSAS group compared with hypertension without OSAS group,including glycosylated hemoglobin,fasting glucose level of systolic blood pressure high blood pressure medication rate N1 percentage REM sleep are statistically significant,P <0.05.Hypertension combined with OSAS group at the end of the average fasting blood glucose at follow-up pure hypertension group were compared with 2010 in the fasting blood glucose,difference was statistically significant,P < 0.05).2.The prevalence of diabetes mellitus(16.6%)and total glucose metabolic disorder(29.8%)in patients with hypertension combined with OSAS was higher than that in patients with hypertension without OSAS(9.2% and 25.4%),but the prevalence of prediabetes mellitus(16.2%)in patients with hypertension without OSAS was higher than that in patients with hypertension combined with OSAS(13.2%),and the difference in prevalence of diabetes between the two groups was statistically significant(P <0.05).It can be seen that the disorder of glucose metabolism(including diabetes and pre-diabetes)increases with the severity of OSAS,with a slight increase of16.8%(20/119),a moderate increase of 32.1%(35/109),and a severe increase of40.5%(49/121).The difference is statistically significant..Among the patients with hypertension complicated with OSAS,there was no significant abnormality in glucosemetabolism disorder in the two groups when compared with those without treatment.Conclusion With the extension of time,compared with patients with hypertension without OSAS,patients with hypertension with OSAS are more likely to have glucose metabolic disorder,and the degree of glucose metabolic disorder is positively correlated with the severity of OSAS.Patients with hypertension with OSAS(especially severe OSAS)should be routinely screened for glucose metabolic disorder. |
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