Department of Geriatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Peking University Health Science Center, Beijing, China.
BMC Musculoskelet Disord. 2024 Nov 21;25(1):939. doi: 10.1186/s12891-024-08070-0.
Obstructive sleep apnea (OSA) significantly affects patients' quality of life; however, the mechanisms, such as its effects on bone mineral density (BMD) and bone turnover marker (BTM) expression, remain unclear. In this study, we investigated the relationships among OSA, BMD, and (BTMs) in older adults.
This retrospective study enrolled 260 participants (114 women; 44.5%). Data of an established system (Alice NightOne) were used to diagnose OSA and analyze nocturnal hypoxia. Participants were divided into four groups according to respiratory event index (REI) (control, < 5 times/hour; mild OSA, 5-15 times/hour; moderate OSA 15-30 times/hour; severe OSA ≥ 30 times/hour). BMD were mesured by dual-energy x-ray absorptiometry. BTMs including bone specific alkaline phosphatase (BALP), tartrate-resistant acid phosphatase 5b (TRAP-5b) were collected.
Patients with OSA had higher BMD at first lumbar vertebra, left and right femur than those without (all p < 0.05). REI was positively correlated with BMD at the first lumbar vertebra (r = 0.181, p = 0.006), left femur (r = 0.160, p = 0.014), and right femur (r = 0.243, p < 0.001). In participants with body mass index (BMI) of 18-24 kg/m (N = 96), the correlation between REI and BMD at the left femur(r = 0.251, p = 0.019) and right femur (r = 0.258, p = 0.018) remained. Multiple regression analysis showed that OSA was significantly associated with osteoporosis (p = 0.034, 95% confidence interval, 0.092-0.100, odds ratio, 0.092). MSaO was positively correlated with TRAP5b (r = 0.560, p = 0.007). In participants with a BMI of ≥ 24 kg/m(N = 164), MSaO was negatively correlated with BALP (r = -0.331, p = 0.034). No significant association between REI and BMD was observed.
OSA and hypoxia were associated with higher BMD in older adults in BMI of 18-24 kg/m but not in participants with a BMI of ≥ 24 kg/m. This study suggests a negative association between OSA and osteoporosis in non-overweight and obese population. BMI played an important role. The study's findings could help exploration mechanisms of osteoporosis and promoting its treatment.
阻塞性睡眠呼吸暂停（OSA）显著影响患者的生活质量；然而，其对骨密度（BMD）和骨转换标志物（BTM）表达的影响等机制仍不清楚。本研究旨在探讨老年人群中 OSA、BMD 和（BTMs）之间的关系。
这是一项回顾性研究，共纳入 260 名参与者（女性 114 名；44.5%）。使用经过验证的系统（Alice NightOne）的数据来诊断 OSA 和分析夜间低氧血症。根据呼吸事件指数（REI）将参与者分为四组（对照组，<5 次/小时；轻度 OSA，5-15 次/小时；中度 OSA，15-30 次/小时；重度 OSA ≥ 30 次/小时）。采用双能 X 线吸收法测量 BMD。收集骨特异性碱性磷酸酶（BALP）、抗酒石酸酸性磷酸酶 5b（TRAP-5b）等 BTM。
与无 OSA 者相比，OSA 患者的第一腰椎、左侧和右侧股骨的 BMD 更高（均 p<0.05）。REI 与第一腰椎（r=0.181，p=0.006）、左侧股骨（r=0.160，p=0.014）和右侧股骨（r=0.243，p<0.001）的 BMD 呈正相关。在 BMI 为 18-24kg/m2 的参与者中（N=96），REI 与左侧股骨（r=0.251，p=0.019）和右侧股骨（r=0.258，p=0.018）的 BMD 之间的相关性仍然存在。多因素回归分析显示，OSA 与骨质疏松显著相关（p=0.034，95%置信区间，0.092-0.100，优势比，0.092）。最低血氧饱和度（MSaO）与 TRAP5b 呈正相关（r=0.560，p=0.007）。在 BMI≥24kg/m2 的参与者中（N=164），MSaO 与 BALP 呈负相关（r=-0.331，p=0.034）。REI 与 BMD 之间无显著相关性。
在 BMI 为 18-24kg/m2 的老年人群中，OSA 和低氧血症与更高的 BMD 相关，但在 BMI≥24kg/m2 的参与者中无相关性。本研究提示在非超重和肥胖人群中，OSA 与骨质疏松之间存在负相关。BMI 起着重要作用。该研究结果有助于探讨骨质疏松的发病机制，并促进其治疗。
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