转氨酶在儿童阻塞性睡眠呼吸暂停低通气综合征中的变化及意义

陈振江; 多力坤

doi:10.13201/j.issn.1001-1781.2013.15.010

转氨酶在儿童阻塞性睡眠呼吸暂停低通气综合征中的变化及意义

陈振江¹,
多力坤^2, ,

- 1. 济宁医学院附属金乡医院儿科(山东济宁, 272200);
- 2. 新疆医科大学第一附属医院儿科
基金项目:
2011年济宁医学院青年基金项目(No:JYQ2011KM050)

详细信息

通讯作者: 多力坤,E-mail:docdlk@tom.com

中图分类号: R766

收稿日期: 2012-09-02

Changes of serum aminotransferase in children with obstructive sleep apnea hypopnea syndrome

CHEN Zhenjiang¹,
DUO Likun^2, ,

- 1. Department of Pediatrics, the Affiliated Jinxiang Hospital of Jining Medical College, Jining, 272200, China;
- 2. Department of Pediatrics, the First Affiliated Hospital of Xinjiang Medical University

More Information

Corresponding author: DUO Likun, E-mail: docdlk@tom.com

Received Date: 02 September 2012

摘要

摘要: 目的:探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是否是引起儿童肝损伤的又一独立危险因素。方法:207例患儿分为OSAHS组（130例）和对照组（77例）,均行PSG、BMI、肝功能、血脂、空腹血糖和空腹胰岛素检查。结果:OSAHS组转氨酶升高者17例,对照组2例,2组比较差异有统计学意义（χ²=5.18,OR=5.64,CI 1.27-24.97）;肥胖组转氨酶升高者15例,非肥胖组4例,2组比较差异有统计学意义（χ²=4.58;OR=1.97,CI 1.06-3.67）;转氨酶升高的脂肪肝组中同时患OSAHS者14例（93.3%）,而转氨酶正常的非脂肪肝组中患OSAHS者37例（67.3%）。结论:OSAHS为独立于肥胖之外的又一引起肝损伤的危险因素。肥胖儿童,尤其是伴有OSAHS的肥胖儿童转氨酶升高更为明显。
- 儿童 /
- 睡眠呼吸暂停低通气综合征,阻塞性 /
- 肥胖 /
- 转氨酶.
Abstract: Objective:Obstructive sleep apnea hypopnea syndrome（OSAHS） and non-alcoholic fatty liver disease（NAFLD） are both strongly associated with obesity.Whether OSAHS is an independent risk factor for liver injury or not is uncertain.To assess the hypothesis that OSAHS is associated with liver injury independent of obesity.Method:One hundred and thirty children with OSAHS and 77 children with primary snoring（PS） were enrolled.Polysomnography was performed.Body mass index（BMI）,liver function tests,serum lipids,fasting plasma glucose（FPG）,and insulin（INS）were measured.Result:Seventeen children of OSAHS had elevated serum aminotransferase levels,while only 2 children of non-OSAHS had elevated serum aminotransferase in healthy control group（χ²=5.18,P<0.05;OR=5.64 CI 1.27-24.97）.Fifteen children of obese had elevated serum aminotransferase levels,while only 4 children had elevated serum aminotransferase in non-obese group（χ²=4.58,P<0.05;OR=1.97 CI 1.06-3.67）.Seventy cases of obese children,15 cases of elevated aminotransferase levels（21.4%）,namely fatty liver patients,of these children,14 had OSAHS（93.3%）.In contrast,OSAHS was present in only 67.3% of obese children without elevated aminotransferase.Conclusion:OSAHS may be a risk factor for liver injury independent of obesity;Increased liver enzyme levels are frequently found in obese snoring children,particularly among those with OSAHS.
- children /
- sleep apnea hypopnea syndrome,obstructive /
- obesity /
- aminotransferase

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参考文献(18)

[1]	ROSEN C L, LARKIN E K, KIRCHNER H L, et al. Prevalence and risk factors for sleep-disordered breathing in 8-to 11-year-old children:association with race and prematurity[J]. J Pediatr,2003,142:383-389.
[2]	UDOMITTIPONG K, CHIERAKUL N, RUTTANAUMPAWAN P, et al. Severe obesity is a risk factor for severe obstructive sleep apnea in obese children[J]. J Med Assoc Thai,2011,94:1346-1351.
[3]	KOHLER M J, THORMAEHLEN S, KENNEDY J D, et al. Differences in the association between obesity and obstructive sleep apnea among children and adolescents[J]. J Clin Sleep Med,2009,15:506-511.
[4]	CANAPARI C A, HOPPIN A G, KINANE T B, et al. Relationship between sleep apnea, fat distribution, and insulin resistance in obese children[J]. J Clin Sleep Med,2011,7:268-273.
[5]	PIGUET A C,STROKA D,ZIMMERMANN A,et al. Hypoxia aggravates non-alcoholic steatohepatitis in mice lacking hepatocellular PTEN[J]. Clin Sci(Lond),2009,118:401-410.
[6]	NORMAN D,BARDWELL W A,AROSEMENA F,et al. Serum aminotransferase levels are associated with markers of hypoxia in patients with obstructive sleep apnea[J]. Sleep,2008,31:121-126.
[7]	VERHULST S L,JACOBS S,AERTS L,et al. Sleep-disordered breathing:a new risk factor of suspected fatty liver disease in overweight children and adolescents[J]? Sleep Breath,2009,13:207-210.
[8]	MARCUS C L, BROOKS L J, DRAPER K A, et al.Diagnosis and management of childhood obstructive sleep apnea syndrome[J]. Pediatrics, 2012,130:576-584.
[9]	李辉,季成叶,宗心南,等.中国0-18岁儿童、青少年体块指数的生长曲线[J].中华儿科杂志,2009,47(7):493-498.
[10]	中华医学会肝病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊疗指南[J].中华肝脏病杂志,2010,18(3):275-278.
[11]	ALMEIDA L A,ANSELMO-LIMA W T,VALERA F C. OSAS in children:where are we[J]? Braz J Otorhinolaryngol,2011,77:273-273.
[12]	SANS CAPDEVILA O, WIENBERG P, HAAG O, et al. Comorbidities of sleep-disordered breathing in children[J]. Acta Otorrinolaringol Esp,2010,61:26-32.
[13]	KHEIRANDISH-GOZAL L,SANS CAPDEVILA O,KHEIRANDISH E,et al.Elevated serum aminotransferase levels in children at risk for obstructive sleep apnea[J]. Chest,2008,133:92-99.
[14]	BYRNE C D. Hypoxia and non-alcoholic fatty liver disease[J]. Clin Sci (Lond),2009,118:397-400.
[15]	NORMAN D,BARDWELL W A,AROSEMENA F,et al. Serum aminotransferase levels are associated with markers of hypoxia in patients with obstructive sleep apnea[J]. Sleep,2008,31:121-126.
[16]	SEYED HAMID MOOSAVY,HOSSEIN FROUTAN,NADER FAIAZI,et al. Effects of obstructive sleep apnea syndrome on serum aminotransferase levels and insulin resistance[J]. Medical Journal of the Islamic Republic of Iran.Vol. 24, No.4, February 2011. 232-237.
[17]	TIAN J L, ZHANG Y, CHEN B Y.Sleep apnea hypopnea syndrome and liver injury[J]. Chin Med J(Engl), 2010,123:89-94.
[18]	AHMED M H, BYRNE C D. Obstructive sleep apnea syndrome and fatty liver:Association or causal link[J]? World J Gastroenterol,2010,16:4243-4252.