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中华肥胖与代谢病电子杂志

中华肥胖与代谢病电子杂志 ›› 2026, Vol. 12 ›› Issue (01) : 16 -22. doi: 10.3877/cma.j.issn.2095-9605.2026.01.003

论著

连续葡萄糖监测指标与阻塞性睡眠呼吸暂停严重程度相关性研究
李转霞, 张梅, 周沁, 李林娟†()   
  1. 716000　延安　延安大学附属医院全科医学科
  • 收稿日期:2025-03-19 出版日期:2026-02-28
  • 通信作者: 李林娟
  • 基金资助:
    陕西省自然科学基金(基金编号：2022JM-471); 延安大学附属医院科学技术研究发展计划项目(基金编号：2021PT-03)

Association between continuous glucose monitoring (CGM) metrics and clinical severity of obstructive sleep apnea

Zhuanxia Li, Mei Zhang, Qin Zhou, Linjuan Li†()   

  1. Department of General Medicine, Yan'an University Affiliated Hospital, Yan'an 716000, China
  • Received:2025-03-19 Published:2026-02-28
  • Corresponding author: Linjuan Li
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引用本文：

李转霞, 张梅, 周沁, 李林娟. 连续葡萄糖监测指标与阻塞性睡眠呼吸暂停严重程度相关性研究[J/OL]. 中华肥胖与代谢病电子杂志, 2026, 12(01): 16-22.

Zhuanxia Li, Mei Zhang, Qin Zhou, Linjuan Li. Association between continuous glucose monitoring (CGM) metrics and clinical severity of obstructive sleep apnea[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2026, 12(01): 16-22.

目的

探讨2型糖尿病（T2DM）患者阻塞性睡眠呼吸暂停（OSA）严重程度与血糖管理指标的关联及临床价值，为T2DM综合管理提供视角。

方法

选取延安大学附属医院2020年2月至2023年2月112例T2DM患者，用多导睡眠监测仪（PSG）评估OSA，依AASM2012标准分为单纯T2DM组（33例）、T2DM+OSA组（79例）。收集一般资料）、生化指标，通过持续血糖监测（CGMS）获取平均血糖（MG）、血糖达标时间占比（TIR）、血糖高于目标范围时间占比（TAR）、血糖低于目标范围时间占比（TBR）及血糖管理指标（GMI）。

结果

T2DM+OSA组空腹血糖（FPG）、糖化血红蛋白（HbA1c）、MG、TAR、TBR、GMI均高于单纯组，TIR低于单纯T2DM组（均P<0.05）。Spearman分析显示，呼吸暂停低通气指数（AHI）与GMI（r=0.56）TAR（r=0.49）正相关，与TIR（r=-0.50）负相关（均P<0.01）。多元回归显示AHI升高与TIR（β=-0.37，P<0.01）降低、MG（β=4.07，P<0.01）升高及GMI（β=7.29，P<0.01）升高独立相关。

结论

CGMS指标MG、TIR、GMI与T2DM患者OSA严重程度紧密相关，可作为评估指标。本研究为优化T2DM综合管理提供依据，后续需探讨OSA作用机制及CGMS临床价值。

关键词: 2型糖尿病, 阻塞性睡眠呼吸暂停, 血糖管理指标, 持续血糖监测系统
Objective

This study aims to explore the relationship between the severity of obstructive sleep apnea (OSA) and blood glucose management in patients with type 2 diabetes mellitus (T2DM). The goal is to provide insights for the comprehensive management of T2DM.

Method

A total of 112 patients with T2DM were selected from Yan'an University Affiliated Hospital between February 2020 and February 2023. OSA was evaluated using polysomnography (PSG) and classified into two groups based on the AASM 2012 standard: a simple T2DM group (33 patients) and a T2DM+OSA group (79 patients). General information and biochemical indicators were collected, and continuous glucose monitoring (CGMS) was used to obtain mean blood glucose (MG), time in range (TIR), time above target range (TAR), time below target range (TBR), and the glucose management indicator (GMI).

Results

The fasting blood glucose (FPG), glycated hemoglobin (HbA1c), MG, TAR, TBR, and GMI values were significantly higher in the T2DM+OSA group compared to the simple T2DM group, while TIR was lower (all P<0.05). Spearman correlation analysis indicated that the apnea-hypopnea index (AHI) was positively correlated with GMI (r=0.56) and TAR (r=0.49), and negatively correlated with TIR (r=-0.50) (all P<0.01). Multiple regression analysis demonstrated that an increase in AHI was independently correlated with a decrease in TIR (β=-0.37, P<0.01), an increase in MG (β=4.07, P<0.01), and an increase in GMI (β=7.29, P<0.01).

Conclusion

CGMS indicators, such as MG, TIR, and GMI, are closely related to the severity of OSA in patients with T2DM and can serve as valuable evaluation tools for this condition. This study provides a foundation for optimizing the comprehensive management of T2DM. Further exploration of the mechanisms linking OSA with diabetes and the clinical value of CGMS is warranted.

Key words: Type 2 Diabetes Mellitus, Obstructive Sleep Apnea, Glycemic Management Indicators, Continuous Glucose Monitoring System
表1 人口学特征
变量 总体 单纯T2DM组 T2DM合并OSA组 t/Z值 P值
n (M/F) 112 (77/35） 33 (21/12） 79 (56/23) 0.75 0.46
Age (y) 52.62±9.83 53.79±8.71 52.14±10.23 0.81 0.42
Diabetes duration (y) 7.00 (2.00, 14.00） 15.00 (5.00, 20.00） 5.00 (2.00, 10.00) -5.73 <0.01
BMI (kg/m2) 27.18±4.08 26.10±1.88 27.63±4.67 -2.48 0.02
SBP (mmHg) 144.14±17.79 140.30±21.64 146.08±15.60 -1.39 0.17
DBP (mmHg) 86.32±10.86 83.33±11.28 87.90±10.17 -2.11 0.04
TG (mmol/L) 2.11 (1.62, 3.24） 1.70 (1.28, 2.14） 2.48 (1.83, 3.82) -4.61 <0.01
TC (mmol/L) 4.09 (2.98, 5.20） 4.03 (2.75, 4.80） 4.15 (3.12, 5.41) -1.08 0.28
HDL-C (mmol/L) 1.01±0.32 1.29±0.24 0.88±0.26 7.80 <0.01
LDL-C (mmol/L) 2.11±0.83 1.88±0.83 2.21±0.82 -1.91 0.06
APO a 1.02±0.23 0.99±0.25 1.02±0.22 -0.82 0.41
APO b 0.78 (0.61, 0.95） 0.72 (0.58, 0.92） 0.81 (0.62, 0.96) -1.28 0.20
Lpa 162.00 (72.00, 262.00） 180.00 (106.50, 373.50） 156.00 (65.00, 243.00) -1.77 0.77
Glycemic Management Indicators    
FPG (mmol/L) 8.88 (7.40, 11.05） 7.80 (6.95, 8.90） 9.40 (7.83, 12.30) -3.59 <0.01
HA1C (%) 8.90 (7.45, 10.25) 7.50 (7.03, 8.99) 9.30 (7.83, 10.68) -3.76 <0.01
MG (mmol/L) 11.23±3.02 8.75±1.82 12.31±2.80 -7.98 <0.01
TAR (%) 64.00 (31.00, 72.00) 28.00 (21.00, 56.50) 70.00 (62.00, 76.00) -6.37 <0.01
TIR (%) 35.00 (28.00, 69.00) 71.00 (42.50, 79.00) 30.00 (23.00, 38.00) -6.38 <0.01
TBR (%) 0.00 (0.00, 1.00) 0.00 (0.00, 0.00) 0.00 (0.00, 1.00) -1.70 0.07
GMI (%) 8.60 (7.30, 9.80) 7.10 (6.50, 8.05) 9.25 (8.22, 10.58) -6.22 0.01
PSG parameters    
AHI (n/hour) 15.40 (3.35, 30.50) 2.60 (1.80, 3.15) 22.50 (14.53, 42.08) -8.32 <0.01
ODI (n/hour) 18.90 (2.60, 29.45) 2.00 (1.80, 2.35) 24.00 (15.10, 34.00) -8.32 <0.01
LSAO2 (%) 80.00 (70.00, 87.50) 92.00 (88.50, 95.00) 74.00 (61.00, 81.00) -8.08 <0.01
TS90% (%) 16.60 (1.90, 28.40) 1.60 (1.20, 1.85) 22.95 (16.20, 31.88) -8.11 <0.01
表2 按OSA严重程度列出的研究受试者的血糖管理指标
变量 单纯T2DM组 T2DM合并OSA组
轻度 中度 重度
n（M/F） 33 (21/12) 21 (13/8) 29 (23/6) 29 (20/9)
Age（years） 53.79±8.71 51.59±8.94 53.69±9.96 51.00±11.59
Diabetes duration（y） 15.31±7.02 7.25±6.09* 6.24±5.72* 5.34±4.82*
BMI（kg/m2） 26.10±1.88 26.34±3.99 28.84±4.44* 27.40±5.12
SBP（mmHg） 140.30±21.64 142.73±17.43 145.21±13.75 148.52±16.54*
DBP（mmHg） 83.33±11.28 85.64±11.50 87.00±9.03 89.55±11.10*
FPG（mmol/L） 7.80 (6.95, 8.90) 8.95 (6.98, 10.83) 9.30 (8.00, 12.20）* 10.40 (8.19, 13.70)*#
HA1C（%） 7.50 (7.00, 8.99) 8.50 (7.18, 10.00) 9.10 (7.80, 10.70）* 9.80 (8.40, 11.60)*#
MG（mmol/L） 8.75±1.82 11.70±2.85* 12.39±2.33* 12.55±3.26*
TAR（%） 28.00 (21.00, 56.50) 67.00 (44.00, 77.25)* 70.00 (62.00, 72.50)* 69.00 (63.50, 77.00)*
TIR（%） 71.00 (42.50, 79.00) 33.00 (22.00, 57.75)* 30.00 (25.00, 38.00)* 30.00 (22.00, 34.50)*
TBR（%） 0.00 (0.00, 0.00) 0.00 (0.00, 0.00) 0.00 (0.00, 1.00)# 1.00 (0.00, 2.00)*#
GMI（%） 7.10 (6.50, 8.05) 8.70 (7.60, 10.20)* 9.60 (8.25, 10.85)* 9.30 (7.95, 10.05)*
表3 多导睡眠图参数与血糖管理指标之间的双变量相关性
  HA1C FPG MG TAR TIR TBR GMI AHI ODI LSAO2 TS90%（%）
HA1C 1                    
FPG 0.74 1                  
MG 0.84 0.56 1                
TAR 0.73 0.60 0.80 1              
TIR -0.74 -0.61 -0.81 -0.99 1            
TBR 0.29 0.29 0.21* 0.26 -0.32 1          
GMI 0.89 0.72 0.94 0.80 -0.81 0.25 1        
AHI 0.39 0.36 0.46 0.49 -0.50 0.29 0.56 1      
ODI 0.31 0.28 0.40 0.42 -0.43 0.20* 0.45 0.92 1    
LSAO2 -0.26 -0.21* -0.36 -0.42 0.42 -0.19* -0.41 -0.85 -0.89 1  
TS90%（%） 0.35 0.34 0.41 0.44 -0.45 0.21* 0.48 0.85 0.85 -0.87 1
表4 AHI对血糖管理指标的影响
Factor β（95%CI） SE t P VIF
TIR -0.37 (-0.59~-0.15) 0.11 -3.28 <0.01 1.89
MG 4.07 (1.06~7.08) 1.53 2.66 <0.01 4.33
GMI 7.29 (2.70~11.88) 2.33 3.13 <0.01 4.67
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