Department of Andrology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Department of rehabilitation medicine, The Northern Medical District of Chinese PLA General Hospital, Beijing, China.
Andrology. 2022 Feb;10(2):223-231. doi: 10.1111/andr.13111. Epub 2021 Sep 30.
Currently, there is no consensus on the effect of obstructive sleep apnea on male serum testosterone levels. This systematic review and meta-analysis aimed to determine the association between obstructive sleep apnea and male serum testosterone level.
The literature related to obstructive sleep apnea and male serum testosterone in the PubMed, Embase, and Cochrane Library databases were searched from their inception to June 10, 2021. Data were pooled using the Stata 15 software. We performed a subgroup analysis of studies after matching the age and body mass index, as well as according to the severity of obstructive sleep apnea.
Eighteen studies involving 1823 men were included in the systematic review and meta-analysis. A significant inverse association between obstructive sleep apnea and male serum testosterone (SMD = -0.76; 95% CI: -1.18, -0.33; p = 0.001) was found. After adjusting for age and body mass index, this inverse association still existed (SMD = -0.8; 95% CI = -1.41, -0.18, p = 0.012). According to the subgroup analysis of obstructive sleep apnea severity, our results showed that serum testosterone was not significantly decreased in mild (SMD = -0.58; 95% CI = -1.88, 0.73, p = 0.386) and moderate obstructive sleep apnea patients (SMD = -0.94; 95% CI = -2.04, 0.15, p = 0.092), whereas it was significantly reduced in patients with severe obstructive sleep apnea (SMD = -1.21; 95% CI = -2.02, -0.41, p = 0.003).
Obstructive sleep apnea is inversely associated with male serum testosterone levels, independent of body mass index and age. Notably, the severity of obstructive sleep apnea is also correlated with male serum testosterone, which is significantly reduced in patients with severe obstructive sleep apnea.
目前，阻塞性睡眠呼吸暂停是否会影响男性血清睾酮水平尚未达成共识。本系统评价和荟萃分析旨在确定阻塞性睡眠呼吸暂停与男性血清睾酮水平之间的关系。
从建库至 2021 年 6 月 10 日，在 PubMed、Embase 和 Cochrane Library 数据库中检索与阻塞性睡眠呼吸暂停和男性血清睾酮相关的文献。使用 Stata 15 软件汇总数据。我们对匹配年龄和体重指数以及根据阻塞性睡眠呼吸暂停严重程度的研究进行了亚组分析。
纳入了 18 项涉及 1823 名男性的系统评价和荟萃分析。阻塞性睡眠呼吸暂停与男性血清睾酮之间存在显著的负相关关系（SMD=-0.76；95%CI：-1.18，-0.33；p=0.001）。在调整年龄和体重指数后，这种负相关仍然存在（SMD=-0.8；95%CI=-1.41，-0.18，p=0.012）。根据阻塞性睡眠呼吸暂停严重程度的亚组分析，我们的结果表明，在轻度（SMD=-0.58；95%CI=-1.88，0.73，p=0.386）和中度阻塞性睡眠呼吸暂停患者中，血清睾酮水平没有显著降低（SMD=-0.94；95%CI=-2.04，0.15，p=0.092），而在重度阻塞性睡眠呼吸暂停患者中则显著降低（SMD=-1.21；95%CI=-2.02，-0.41，p=0.003）。
阻塞性睡眠呼吸暂停与男性血清睾酮水平呈负相关，与体重指数和年龄无关。值得注意的是，阻塞性睡眠呼吸暂停的严重程度也与男性血清睾酮有关，在重度阻塞性睡眠呼吸暂停患者中，血清睾酮显著降低。
