Kuczyński Wojciech, Gabryelska Agata, Mokros Łukasz, Białasiewicz Piotr
Department of Sleep Medicine and Metabolic Disorders, Medical University in Lodz, Poland.
Pneumonol Alergol Pol. 2016;84(5):302-6. doi: 10.5603/PiAP.2016.0038.
The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients.
阻塞性睡眠呼吸暂停低通气综合征（OSAHS）在男性中的患病率为4%至7%，在女性中为2%至5%。其有害后果，如交通事故、心血管并发症导致发病率和死亡率增加，使其成为一个主要的健康问题。除肥胖（OSAHS的主要危险因素）外，甲状腺功能减退患者也容易出现这种症状。尽管甲状腺功能减退似乎是OSAHS公认的危险因素，但一些作者报告称缺乏临床相关关联。这种观点部分取决于OSAHS患者中甲状腺功能减退患病率的增加，但流行病学数据有限且在某种程度上不一致；关于OSAHS患者亚临床甲状腺功能减退的情况知之更少。即使OSAHS患者中显性和亚临床甲状腺功能减退的发生率与普通人群相当，但对其进行筛查似乎是有益的，因为激素替代疗法可能改善睡眠呼吸紊乱。不幸的是，仅在少数针对甲状腺功能减退患者数量有限的研究中发现了这种有利结果。然而，尽管缺乏国际指南且尚无关于该主题的大型多中心研究，但我们认为促甲状腺激素筛查可能对绝大多数OSAHS患者有益。
