Yen Chia-Ming, Kuo Chi-Ling, Lin Ming-Chia, Lee Chun-Feng, Lin Kuan-Yu, Lin Cheng-Li, Chang Shih-Ni, Sung Fung-Chang, Kao Chia-Hung
Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan.
Department of Nuclear Medicine, New Taipei City Hospital, Sanchong Branch, Taipei, Taiwan.
Sleep Med. 2014 Nov;15(11):1339-44. doi: 10.1016/j.sleep.2014.07.005. Epub 2014 Aug 1.
This study evaluated the relationship between sleep disorders (SDs) and osteoporosis risk in Taiwan.
From the Taiwan National Health Insurance data, we identified 44,690 newly diagnosed SD patients (846 with apnea and 43,844 without) from 1998 to 2001 and 89,380 comparisons without SD in the same period frequency matched by sex, age and diagnosis year. Incident osteoporosis was measured by the end of 2010.
Patients with apnea-SD and nonapnea SD exhibited a higher osteoporosis incidence rate than did the comparisons (9.97 and 13.3 vs. 6.77 per 1000 person-years, respectively). The Cox method estimated adjusted hazard ratio (HR) of osteoporosis was 2.98 (95% confidence interval [CI] = 2.36-3.74) in apnea-SD patients, compared with 2.76 (95% CI = 2.64-2.88) in nonapnea-SD patients after controlling for sex, age, comorbidities, and treatment. Greater HRs of osteoporosis were observed for female patients (4.00, 95% CI = 3.72-4.29) and those aged >64 years (42.0, 95% CI = 33.5-52.7) in the apnea SD sub-cohort. Apnea SD was associated with the highest risk of osteoporosis without fracture compared with both the nonapnea SD sub-cohort and comparisons.
Patients with sleep disorders have an elevated risk of osteoporosis, especially for women and the elderly.
本研究评估了台湾地区睡眠障碍（SDs）与骨质疏松症风险之间的关系。
从台湾国民健康保险数据中，我们识别出1998年至2001年期间44690例新诊断的SD患者（846例有呼吸暂停，43844例无呼吸暂停），并在同一时期按性别、年龄和诊断年份进行频率匹配，选取89380例无SD的对照。到2010年底时测量新发骨质疏松症情况。
呼吸暂停性SD和非呼吸暂停性SD患者的骨质疏松症发病率高于对照组（分别为每1000人年9.97例和13.3例，而对照组为6.77例）。在控制了性别、年龄、合并症和治疗因素后，采用Cox方法估计，呼吸暂停性SD患者骨质疏松症的调整后风险比（HR）为2.98（95%置信区间[CI]=2.36-3.74），非呼吸暂停性SD患者为2.76（95%CI=2.64-2.88）。在呼吸暂停性SD亚组中，女性患者（4.00，95%CI=3.72-4.29）和年龄>64岁的患者（42.0，95%CI=33.5-52.7）的骨质疏松症HR更高。与非呼吸暂停性SD亚组和对照组相比，呼吸暂停性SD与无骨折的骨质疏松症最高风险相关。
睡眠障碍患者骨质疏松症风险升高，尤其是女性和老年人。
