肥胖与阻塞性睡眠呼吸暂停中的骨质流失：文献综述
Bone loss in obesity and obstructive sleep apnea: a review of literature.
作者信息
Chakhtoura Marlene, Nasrallah Mona, Chami Hassan
机构信息
Division of Endocrinology at the American University of Beirut, Beirut Lebanon.
Division of Pulmonary, Sleep and Critical Care Medicine at the American University of Beirut, Beirut Lebanon.
出版信息
J Clin Sleep Med. 2015 Apr 15;11(5):575-80. doi: 10.5664/jcsm.4708.
INTRODUCTION
Obstructive sleep apnea (OSA) is a common sleep-related respiratory disorder. It is associated with many endocrinopathies including hypogonadotropic hypogonadism, hypercortisolism, and glucose intolerance that may lead to bone loss with secondary osteoporosis.
METHODS
We report the case of a 41-year-old man who presented with bilateral 9th rib fractures and was found to have obstructive sleep apnea and osteoporosis. We also present a literature review on this topic.
RESULTS
OSA can lead to bone loss through various mechanisms. Some are shared with obesity, including hypogonadism, altered adrenergic tone, inflammation, oxidative stress, vitamin D deficiency and diabetes mellitus; others are specific to OSA, such as hypoxia and altered glucocorticoids regulation.
CONCLUSION
There are no guidelines on screening for osteoporosis in OSA. Further research is needed to assess the incidence of bone loss and fractures in OSA.
引言
阻塞性睡眠呼吸暂停（OSA）是一种常见的与睡眠相关的呼吸系统疾病。它与许多内分泌疾病有关，包括低促性腺激素性性腺功能减退、皮质醇增多症和葡萄糖不耐受，这些疾病可能导致骨质流失继发骨质疏松症。
方法
我们报告了一例41岁男性病例，该患者出现双侧第9肋骨骨折，被发现患有阻塞性睡眠呼吸暂停和骨质疏松症。我们还对该主题进行了文献综述。
结果
OSA可通过多种机制导致骨质流失。其中一些机制与肥胖相同，包括性腺功能减退、肾上腺素能张力改变、炎症、氧化应激、维生素D缺乏和糖尿病；其他机制则是OSA特有的，如缺氧和糖皮质激素调节改变。
结论
目前尚无关于OSA患者骨质疏松症筛查的指南。需要进一步研究以评估OSA患者骨质流失和骨折的发生率。
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