持续气道正压通气治疗可改善重度阻塞性睡眠呼吸暂停综合征男性的骨密度。

Continuous positive airway pressure treatment improves bone mineral density in men affected by severe obstructive sleep apnea syndrome.

机构信息

Sleep Medicine Centre, Neurology Unit, University Hospital of Rome "Tor Vergata," Rome, Italy.

Neurocenter of Southern Switzerland, Lugano, Switzerland.

出版信息

J Clin Sleep Med. 2024 Jan 1;20(1):67-73. doi: 10.5664/jcsm.10796.

DOI:10.5664/jcsm.10796

PMID:37677073

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10758556/

Abstract

STUDY OBJECTIVES

Obstructive sleep apnea (OSA) and low bone mineral density (BMD) are 2 prevalent conditions with a significant negative impact on patients' well-being and quality of life. Recent research has shown low BMD at different bone sites in male patients with OSA. Although the efficacy of continuous positive airway pressure (CPAP) treatment for OSA has been widely demonstrated, the evidence for understanding its impact on BMD and other bone-related outcomes is insufficient. The aim of this observational study was to investigate the effect of 12 months of CPAP treatment on lumbar and femur BMD and bone-related serum biomarkers in male patients with severe OSA.

METHODS

Sixty patients (mean age: 55.1 ± 9.9 years) were consecutively included and underwent BMD measurement with dual-energy x-ray absorptiometry at baseline and after 12 months of CPAP treatment. Vitamin D, parathyroid hormone, and calcium serum levels were examined at the same time points.

RESULTS

A significant increase in BMD in the L1 ( < .001, = 0.27) and L2 ( < .001, = 0.26) vertebrae was observed after CPAP treatment, along with an increase in vitamin D ( < .001, = 0.71) and calcium ( < .001, = 0.73) levels and a decrease in parathyroid hormone levels ( < .001, = 0.60). The increase in BMD in L1 was significantly correlated with the decrease in parathyroid hormone serum levels ( = -.50, < .001).

CONCLUSIONS

Overall, these findings showed that beneficial OSA treatment might restore bone health and support CPAP treatment as a feasible strategy to improve BMD in male patients with severe OSA. Accordingly, diagnosing and targeting OSA may be warranted in the treatment of male patients with undetermined osteopenia and osteoporosis.

CITATION

Carpi M, Cordella A, Placidi F, et al. Continuous positive airway pressure treatment improves bone mineral density in men affected by severe obstructive sleep apnea syndrome. . 2024;20(1):67-73.

摘要

研究目的

阻塞性睡眠呼吸暂停（OSA）和低骨密度（BMD）是两种普遍存在的疾病，对患者的健康和生活质量有重大负面影响。最近的研究表明，男性 OSA 患者在不同的骨部位存在低 BMD。虽然持续气道正压通气（CPAP）治疗 OSA 的疗效已得到广泛证实，但对于理解其对 BMD 和其他骨骼相关结局的影响的证据还不足。本观察性研究的目的是探讨 12 个月 CPAP 治疗对男性重度 OSA 患者腰椎和股骨 BMD 及骨骼相关血清生物标志物的影响。

方法

连续纳入 60 例患者（平均年龄：55.1±9.9 岁），分别在基线和 CPAP 治疗 12 个月后进行双能 X 线吸收法测量 BMD，并同时检测血清维生素 D、甲状旁腺激素和钙水平。

结果

CPAP 治疗后 L1（ <.001， = 0.27）和 L2（ <.001， = 0.26）椎体的 BMD 显著增加，同时维生素 D（ <.001， = 0.71）和钙（ <.001， = 0.73）水平升高，甲状旁腺激素水平降低（ <.001， = 0.60）。L1 处 BMD 的增加与甲状旁腺激素血清水平的降低显著相关（ = -.50， <.001）。