成人阻塞性睡眠呼吸暂停与低骨量之间的关联：一项系统评价和荟萃分析。
Association between obstructive sleep apnea and low bone mass in adults: a systematic review and meta-analysis.
作者信息
Wang Xin-Yuan, Wang Xin-Yu, Liao Zhi-Xin, Zhao Yue-An, Wei Chang, Gong Lin-Jing
机构信息
Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041 Sichuan China.
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041 Sichuan China.
出版信息
Sleep Biol Rhythms. 2023 Aug 10;22(1):65-73. doi: 10.1007/s41105-023-00481-1. eCollection 2024 Jan.
INTRODUCTION
This study aimed to synthesize existing evidence on the potential association between obstructive sleep apnea (OSA) and low bone mass in adults.
METHODS
Electronic searches of four main databases were performed. The inclusion criteria consisted of observational studies investigating the relationship between OSA and bone mass, osteoporosis, fractures, or bone metabolism markers in adult population. Bone mineral density (BMD) and T score of lumbar and femur neck, incidence of osteoporosis and fractures, bone metabolism marker levels were extracted as primary outcomes.
RESULTS
Among the 693 relevant publications, 10 studies consisting of 158,427 participants met with the inclusion and exclusion criteria. Meta-analysis showed a significant lower BMD of lumbar (mean difference (MD) = - 0.03; 95% CI - 0.05, - 0.01; I = 46%), femur neck (MD = - 0.06; 95% CI - 0.12, 0.00; I = 71%), and a significant lower T score of lumbar (MD = - 0.42; 95% CI - 0.79, - 0.05; I = 63%) in the OSA group. The results suggested that both male (odds ratio (OR) = 2.03; 95% CI 1.23, 3.35; I = 38%) and female (OR = 2.56; 95% CI 1.96, 3.34; = 0%) had higher risk of osteoporosis in the OSA group. Besides, meta-analysis also showed that bone-specific alkaline phosphatase was significantly lower in OSA patients (MD = - 1.90; 95% CI - 3.48, - 0.32; = 48%).
CONCLUSIONS
A potential association between OSA and lower bone mass in adults is preliminarily proved. It also seems plausible that both male and female with OSA have a higher risk of osteoporosis.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s41105-023-00481-1.
引言
本研究旨在综合现有证据，探讨成人阻塞性睡眠呼吸暂停（OSA）与低骨量之间的潜在关联。
方法
对四个主要数据库进行电子检索。纳入标准包括针对成年人群中OSA与骨量、骨质疏松症、骨折或骨代谢标志物之间关系的观察性研究。提取腰椎和股骨颈的骨密度（BMD）及T值、骨质疏松症和骨折的发生率、骨代谢标志物水平作为主要结局指标。
结果
在693篇相关出版物中，10项研究（共158,427名参与者）符合纳入和排除标准。荟萃分析显示，OSA组的腰椎BMD显著降低（平均差（MD）=-0.03；95%置信区间 -0.05，-0.01；I²=46%），股骨颈BMD显著降低（MD=-0.06；95%置信区间 -0.12，0.00；I²=71%），腰椎T值也显著降低（MD=-0.42；95%置信区间 -0.79，-0.05；I²=63%）。结果表明，OSA组男性（优势比（OR）=2.03；95%置信区间 1.23，3.35；I²=38%）和女性（OR=2.56；95%置信区间 1.96，3.34；I²=0%）患骨质疏松症的风险均较高。此外，荟萃分析还显示，OSA患者的骨特异性碱性磷酸酶显著降低（MD=-1.90；95%置信区间 -3.48，-0.32；I²=48%）。
结论
初步证明了OSA与成人低骨量之间存在潜在关联。OSA男性和女性患骨质疏松症的风险较高似乎也合理。
补充信息
在线版本包含可在10.1007/s41105-023-00481-1获取的补充材料。
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