Bercea Raluca Mihaela, Mihaescu Traian, Cojocaru Cristian, Bjorvatn Bjørn
'Grigore T. Popa' University of Medicine and Pharmacy, Iasi, Romania.
Clinic of Pulmonary Diseases, Iasi, Romania.
Clin Respir J. 2015 Jul;9(3):342-9. doi: 10.1111/crj.12150. Epub 2014 May 5.
Obstructive sleep apnea (OSA)-related fatigue is a common understudied symptom. Fatigue is associated with low serum testosterone level in non-OSA patients. No data are available about this association in OSA patients.
To investigate in adult obese males affected by OSA, the relationship between fatigue and serum testosterone in order to identify predictors for OSA-related fatigue.
Fifteen OSA patients and 15 control subjects participated. The parameters analyzed were serum testosterone morning concentration, polysomnography parameters, daytime sleepiness (Epworth Sleepiness Scale) and fatigue (Multidimensional Fatigue Inventory). Regression test was applied in order to show predictors of fatigue. Kruskal-Wallis test followed by post-hoc analysis was performed to test for differences between controls and OSA subgroups for testosterone, fatigue components and sleepiness.
Mean testosterone level was 3.55 ± 0.7 ng/mL in the OSA group, significantly lower than in controls (4.26 ± 1.1 ng/mL, P = 0.049). An inverse correlation was found between testosterone and fatigue scores (P < 0.01). Furthermore, a statistically significant difference was found between the control group and the severe OSA subgroup for general fatigue, physical fatigue, reduced activity and mental fatigue. However, no significant differences were found between controls and mild OSA. Among all variables, testosterone was the only independent significant predictor of physical fatigue (t = -2.56, P = 0.033, R = 0.978, R(2) = 0.958) and reduced activity (t = -4.41, P = 0.002, R = 0.966, R(2) = 0.934) in the OSA patients.
OSA-related fatigue was strongly associated with serum testosterone, together with OSA severity.
阻塞性睡眠呼吸暂停（OSA）相关的疲劳是一种常见但研究不足的症状。在非OSA患者中，疲劳与血清睾酮水平低有关。目前尚无关于OSA患者中这种关联的数据。
在成年肥胖男性OSA患者中，研究疲劳与血清睾酮之间的关系，以确定OSA相关疲劳的预测因素。
15名OSA患者和15名对照受试者参与研究。分析的参数包括血清睾酮早晨浓度、多导睡眠图参数、白天嗜睡程度（爱泼沃斯嗜睡量表）和疲劳程度（多维疲劳量表）。应用回归测试以显示疲劳的预测因素。进行Kruskal-Wallis检验并随后进行事后分析，以检验对照组与OSA亚组在睾酮、疲劳成分和嗜睡方面的差异。
OSA组的平均睾酮水平为3.55±0.7 ng/mL，显著低于对照组（4.26±1.1 ng/mL，P = 0.049）。发现睾酮与疲劳评分之间存在负相关（P < 0.01）。此外，在一般疲劳、身体疲劳、活动减少和精神疲劳方面，对照组与重度OSA亚组之间存在统计学显著差异。然而，对照组与轻度OSA之间未发现显著差异。在所有变量中，睾酮是OSA患者身体疲劳（t = -2.56，P = 0.033，R = 0.978，R² = 0.958）和活动减少（t = -4.41，P = 0.002，R = 0.966，R² = 0.934）的唯一独立显著预测因素。
OSA相关的疲劳与血清睾酮以及OSA严重程度密切相关。
