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ORIGINAL ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 16  |  Page : 1898-1903

Bone Metabolic Markers in Patients with Obstructive Sleep Apnea Syndrome


1 Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
2 Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, China

Correspondence Address:
Dr. Xiao-Ling Gao
Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.238149

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Background: Obstructive sleep apnea syndrome (OSAS) is prevalent in obesity and is associated with many metabolic abnormalities. The relationship between OSAS and bone metabolism is still unclear. The aim of this study was to investigate the relationship between the severity of OSAS and bone metabolic markers. Methods: A total of 119 obese males were enrolled in this study in spring months from 2015 to 2017. All candidates underwent polysomnography, and their bone mineral density (BMD) and the serum levels of total procollagen type 1 N-terminal propeptide (t-P1NP), N-terminal midfragment of osteocalcin (N-MID), β-C-terminal telopeptide of type 1 collagen (β-CTX), vitamin D (VD), and parathyroid hormone (PTH) were measured. The analysis of variance and Pearson correlation analysis were performed for data analyses. Results: No significant differences in the mean values of BMD were observed among the obesity, mild-to-moderate OSAS, and severe OSAS groups; and the serum levels of t-P1NP and β-CTX in the severe OSAS group were significantly higher than those in the obesity group (48.42 ± 23.78 ng/ml vs. 31.98 ± 9.85 ng/ml, P < 0.001; 0.53 ± 0.24 ng/ml vs. 0.41 ± 0.13 ng/ml, P = 0.011, respectively). The serum level of VD in the obesity group was significantly higher than those in the mild-to-moderate and severe OSAS groups (both P < 0.001), and decreased as the severity of OSAS increased (P < 0.001). The serum level of PTH in the severe OSAS group was significantly higher than those in the obesity and mild-to-moderate OSAS groups (both P < 0.001). The results of correlation analysis indicated that the level of apnea-hypopnea index (AHI) was correlated with the levels of t-P1NP (r = 0.396, P < 0.001), VD (r = –0.404, P < 0.001), and PTH (r = 0.400, P < 0.001), whereas the level of minimum O2saturation (SaO2min) was correlated with the levels of VD (r = 0.258, P = 0.016) and PTH (r = –0.376, P < 0.001). Conclusions: The levels of bone resorption and formation markers in patients with severe OSAS were significantly increased compared to obese men, and the severity of OSAS was correlated with the serum levels of t-P1NP, VD, and PTH.

 

 Abstract in Chinese

阻塞性睡眠呼吸暂停综合征患者骨代谢标志物的研究

摘要

背景:阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)多见于肥胖人群,且与多种代谢性疾病相关,而OSAS与骨代谢的关系至今仍未明确。此研究旨在探讨OSAS严重程度与骨代谢标志物的关系。

方法:纳入了2015年至2017年春季来诊的119名肥胖男性。所有参与者行多导睡眠监测,并测量骨密度(bone mineral density,BMD)及血清总I型胶原氨基端延长肽(total procollagen type1 N-terminal propeptide,t-P1NP)、N-端骨钙素(N-terminal midfragment of osteocalcin, N-MID)、β-胶原特殊序列(β-C-terminal telopeptide of type 1 collagen,β-CTX)、维生素D(vitamin D,VD)和甲状旁腺激素(parathyroid hormone,PTH)的水平。数据分析采用方差分析及Pearson相关分析。

结果:肥胖对照组、轻中度OSAS及重度OSAS组患者的BMD水平无明显差异,而重度OSAS组血清t-P1NP 和β-CTX的水平均明显高于肥胖对照组 (48.42±23.78 ng/ml vs. 31.98±9.85 ng/ml, P<0.001; 0.53±0.24 ng/ml vs. 0.41±0.13 ng/ml, P =0.011)。肥胖组的VD水平明显高于轻中度OSAS组 (P <0.001)和重度OSAS组 (P <0.001),且重度OSAS组的VD水平低于轻中度OSAS组 (P <0.001)。重度OSAS组的PTH水平明显高于轻中度OSAS组(P <0.001)及肥胖组 (P <0.001)。相关性分析显示睡眠呼吸暂停低通气指数(apnea-hypopnea index,AHI)与t-P1NP(r=0.396, P <0.001)、VD(r=-0.404, P <0.001)、PTH(r=0.400, p<0.001)相关,夜间最低血氧(minimum O2 saturation,SaO2min)与VD(r=0.258, P =0.016)和PTH(r=-0.376, P <0.001)相关。

结论与男性肥胖人群相比,男性重度OSAS患者的骨吸收及骨形成标志物明显升高,OSAS的严重程度与血清t-P1NP、VD及PTH相关。



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