Chen Dong-Dong, Huang Jie-Feng, Lin Qi-Chang, Chen Gong-Ping, Zhao Jian-Ming
Department of Respiratory Medicine, Fujian Provincial Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease, The First Affiliated Hospital of Fujian Medical University, NO 20, Chazhong Road, Taijiang District, Fuzhou, Fujian Province, People's Republic of China, 350005.
Sleep Breath. 2017 May;21(2):557-564. doi: 10.1007/s11325-017-1492-7. Epub 2017 Mar 25.
Obstructive sleep apnea syndrome (OSAS) is reported to have an association with bone mineral density (BMD). However, the underlying mechanism is far from clear. The aim of this study was to investigate the relationship between OSAS, bone turnover markers, and BMD and to evaluate the effect of adiponectin on BMD in patients with OSAS.
Seventy-one male patients with OSAS and 13 male control subjects were enrolled in this study. Serum adiponectin, calcium, phosphorus, 25-hydroxyvitamin-D3, β-isomerized form C-terminal telopeptide of type I collagen, osteocalcin, and procollagen type 1 N-propeptide were measured in all subjects, and BMD was evaluated by dual-energy X-ray absorptiometry (DEXA) in the lumbar spine (L1-L4), the femoral neck, and the hip total.
No statistically significant differences were found between the studied groups in terms of demographic data and bone turnover markers. Serum adiponectin significantly decreased with the aggravation of OSAS. Compared with subjects without OSAS, those with OSAS had a higher hip total BMD and t scores (p = 0.027 and p = 0.028). The significant negative association was found between serum adiponectin levels and hip total BMD. After adjusting for confounders, adiponectin as well as oxygen desaturation index (ODI) significantly predicted the hip total BMD (β = -0.232, p = 0.005 and β = 0.226, p = 0.037).
In male subjects, the presence of obstructive sleep apnea syndrome is associated with higher bone mineral density of the hip. These findings suggest that serum adiponectin may be an underlying mediator for BMD in OSAS.
据报道，阻塞性睡眠呼吸暂停综合征（OSAS）与骨密度（BMD）有关。然而，其潜在机制尚不清楚。本研究旨在探讨OSAS、骨转换标志物和BMD之间的关系，并评估脂联素对OSAS患者BMD的影响。
本研究纳入了71例男性OSAS患者和13例男性对照者。检测了所有受试者的血清脂联素、钙、磷、25-羟基维生素D3、I型胶原β-异构化C末端肽、骨钙素和I型前胶原N端前肽，并采用双能X线吸收法（DEXA）评估腰椎（L1-L4）、股骨颈和全髋部的BMD。
研究组之间在人口统计学数据和骨转换标志物方面未发现统计学显著差异。血清脂联素随OSAS的加重而显著降低。与无OSAS的受试者相比，患有OSAS的受试者全髋部BMD和t值更高（p = 0.027和p = 0.028）。血清脂联素水平与全髋部BMD之间存在显著负相关。在调整混杂因素后，脂联素以及氧饱和度下降指数（ODI）显著预测了全髋部BMD（β = -0.232，p = 0.005和β = 0.226，p = 0.037）。
在男性受试者中，阻塞性睡眠呼吸暂停综合征的存在与髋部较高的骨密度有关。这些发现表明，血清脂联素可能是OSAS中BMD的潜在调节因子。
