Effect of continuous positive airway pressure＇s treatment on type 2 diabetes mellitus with obstructive sleep apnea syndrome patients：A meta-analysis

目的：系统评价持续气道正压通气（CPAP）治疗对2型糖尿病合并阻塞性睡眠呼吸暂停综合征（OSAS）患者的血糖代谢及呼吸参数的治疗效果。方法：应用Cochrane系统评价方法检索Pub Med、Cochrane Library、Web of Science、EMBASE、CBM、CNKI和万方数据库,同时在Google搜索引擎进行检索,收集CPAP对比常规治疗或安慰剂治疗的随机对照试验（RCT）。根据Cochrane协作网推荐的＂风险评估工具＂进行风险偏倚评估,用Review Manager 5.0软件进行统计学分析。结果：最终纳入16个RCT,共945例患者。Meta分析结果显示,对于2型糖尿病合并OSAS患者,CPAP治疗能改善患者的胰岛素抵抗、糖化血红蛋白、呼吸暂停低通气指数、Epworth嗜睡量表评分、最低血氧饱和度及患者的生活质量,CPAP对于空腹血糖的影响无统计学意义。所有研究均未对CPAP治疗的不良反应进行报道。结论：CPAP能改善2型糖尿病合并OSAS患者胰岛素抵抗、糖化血红蛋白、夜间缺氧,可以改善患者的生活质量,但还需要更大量的高质量文献提供科学的证据。Objective：To systematically review the evidence for the effect of continuous positive airway pressure＇s treatment on type 2diabetes mellitus with obstructive sleep apnea syndrome in people. Methods：The searched databases were including Pub Med,Cochrane Library,Web of Science,EMBASE,CNKI,WANFANG Database,CBM Database and Google search engine etc. for randomized controlled trials comparing CPAP with placebo or conventional treatment. Researchers extracted data on apnea-hypopnea index,the Epworth Sleeping Scale（ESS）,LSp O2,homeostasis model assessment of insulin resistance（HOMA-IR）,fasting blood glucose（FBG）,and Hb A1C（%）. All data were analyzed using Review Manager 5.0. Results：Sixteen studies involving 945 participants were included. The results of meta-analysis showed that：（1）For people who are type 2 diabetes mellitus with obstructive sleep apnea syndrome,meta-analysis showed an improvement in AHI,in ESS,in LSp O2,in HOMA-IR,in Hb A1 c and in quality of life,no significant improvement in FBG.（2）No serious adverse events were associated with the administration of CPAP. Conclusion：CPAP can improve insulin resistance,glycosylated hemoglobin,nocturnal hypoxia and the quality of life in type 2 diabetic patients with OSAS,but also need to provide scientific evidence for a large number of high quality literature