Sriphrapradang Chutintorn, Pinyopodjanard Sittichai, Suntornlohanakul Onnicha, Nimitphong Hataikarn, Chirakalwasan Naricha, Saetang Sunee, Anothaisintawee Thunyarat, Siwasaranond Nantaporn, Manodpitipong Areesa, Chailurkit La-Or, Reutrakul Sirimon
Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Sleep Breath. 2019 Sep;23(3):963-967. doi: 10.1007/s11325-018-1756-x. Epub 2018 Nov 19.
Hypothyroidism is associated with a high frequency of obstructive sleep apnea (OSA). However, the prevalence of OSA in hypothyroid patients is not different from the general population in many reports. The importance of thyroid function screening in sleep-disordered breathing is still controversial. This study aimed to explore the association between thyroid dysfunction and OSA in the adults with prediabetes or diabetes mellitus type 2, who have very high prevalence of OSA.
OSA was assessed using an in-home monitoring device, WatchPAT200. OSA severity was measured using apnea-hypopnea index (AHI), oxygen desaturation index (ODI), minimum oxygen saturation (minO2), and time spent under oxygen saturation < 90% (T90). Patients with pre-existing thyroid dysfunction were excluded.
Participants included 70 men and 118 women with mean age 52.8 ± 10.9 years and body mass index 28.2 ± 4.9 kg/m. One hundred forty participants (75%) had OSA, with a median AHI of 10.1 (interquartile range 4.8, 18.3). The percentage of positive thyroid autoantibody (thyroperoxidase and thyroglobulin antibody) was similar among the subjects with and without OSA. There was no correlation between the levels of thyroid function (TSH, FT3, FT4, TSH/FT3, and TSH/FT4 ratio) and the severity indices of OSA (AHI, ODI, minO2, and T90).
These data do not support universal screening for thyroid dysfunction in OSA patients with diabetes or prediabetes.
甲状腺功能减退与阻塞性睡眠呼吸暂停(OSA)的高发生率相关。然而,许多报告显示甲状腺功能减退患者中OSA的患病率与普通人群并无差异。甲状腺功能筛查在睡眠呼吸障碍中的重要性仍存在争议。本研究旨在探讨甲状腺功能障碍与2型糖尿病前期或2型糖尿病成年患者中OSA的关联,这些患者中OSA的患病率非常高。
使用家用监测设备WatchPAT200评估OSA。使用呼吸暂停低通气指数(AHI)、氧饱和度下降指数(ODI)、最低氧饱和度(minO2)以及氧饱和度<90%的时间(T90)来衡量OSA的严重程度。排除既往存在甲状腺功能障碍的患者。
参与者包括70名男性和118名女性,平均年龄52.8±10.9岁,体重指数28.2±4.9kg/m²。140名参与者(75%)患有OSA,AHI中位数为10.1(四分位间距4.8,18.3)。甲状腺自身抗体(甲状腺过氧化物酶和甲状腺球蛋白抗体)阳性的百分比在有和没有OSA的受试者中相似。甲状腺功能水平(促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素/游离三碘甲状腺原氨酸以及促甲状腺激素/游离甲状腺素比值)与OSA严重程度指标(AHI、ODI、minO2和T90)之间无相关性。
这些数据不支持对患有糖尿病或糖尿病前期的OSA患者进行甲状腺功能障碍的普遍筛查。