Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, HI, USA.
School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Sleep Med. 2018 Mar;43:100-108. doi: 10.1016/j.sleep.2017.10.016. Epub 2017 Dec 14.
OBJECTIVE/BACKGROUND: Several studies have reported an association between 25-hydroxyvitamin D (25(OH)D) levels and obstructive sleep apnea (OSA) patients. The objective of the current study was to perform a systematic review and meta-analysis of these studies and report the findings.
PATIENTS/METHODS: Authors searched for studies (through January 1, 2017) reporting 25(OH)D serum levels in OSA patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed.
Fourteen studies with 4937 subjects met inclusion criteria. There were 1513 controls and 3424 OSA patients. The 25(OH)D serum levels for controls and mild OSA patients were 28.16 ± 9.39 ng/mL (95% CI 27.64, 28.68) and 27.41 ± 9.42 ng/mL (95% CI 26.87, 27.95), respectively. The 25(OH)D serum levels for controls and moderate OSA patients were 28.21 ± 9.38 ng/mL (95% CI 27.70, 28.72) and 25.48 ± 10.34 ng/mL (95% CI 24.68, 26.28), respectively. The 25(OH)D serum levels for controls and severe OSA patients were 28.32 ± 9.65 ng/mL (95% CI 27.80, 28.84) and 21.88 ± 10.24 ng/mL (95% CI 21.08, 22.68), respectively. Using random effects modeling, the 25(OH)D serum levels were decreased for patients with OSA when compared to control groups (mean differences were -2.7% for mild OSA, -10.1% for moderate OSA and -17.4% for severe OSA).
There was a relative insufficiency in serum 25(OH)D levels among OSA patients compared to control patients, which was incrementally exacerbated with increasing severity of sleep apnea. It was unclear whether a low 25(OH)D was a risk factor for OSA or if OSA was a risk factor for 25(OH)D. It was also possible that the association between 25(OH)D and OSA was due to body mass index (BMI).
目的/背景：几项研究报告了 25-羟维生素 D（25(OH)D）水平与阻塞性睡眠呼吸暂停（OSA）患者之间存在关联。本研究的目的是对这些研究进行系统评价和荟萃分析，并报告研究结果。
患者/方法：作者检索了截至 2017 年 1 月 1 日报告 OSA 患者 25(OH)D 血清水平的研究。遵循系统评价和荟萃分析的首选报告项目（PRISMA）声明。
共有 14 项研究纳入了 4937 例受试者，其中对照组 1513 例，OSA 患者 3424 例。对照组和轻度 OSA 患者的 25(OH)D 血清水平分别为 28.16±9.39ng/ml（95%CI 27.64，28.68）和 27.41±9.42ng/ml（95%CI 26.87，27.95），对照组和中度 OSA 患者的 25(OH)D 血清水平分别为 28.21±9.38ng/ml（95%CI 27.70，28.72）和 25.48±10.34ng/ml（95%CI 24.68，26.28），对照组和重度 OSA 患者的 25(OH)D 血清水平分别为 28.32±9.65ng/ml（95%CI 27.80，28.84）和 21.88±10.24ng/ml（95%CI 21.08，22.68）。使用随机效应模型，与对照组相比，OSA 患者的 25(OH)D 血清水平降低（轻度 OSA 的平均差异为-2.7%，中度 OSA 为-10.1%，重度 OSA 为-17.4%）。
与对照组相比，OSA 患者的血清 25(OH)D 水平相对不足，随着睡眠呼吸暂停严重程度的增加而逐渐恶化。目前尚不清楚低 25(OH)D 是 OSA 的危险因素，还是 OSA 是 25(OH)D 的危险因素。也有可能 25(OH)D 与 OSA 之间的关联是由于体重指数（BMI）。
