The relationship between sex hormone and bone mineral density in male patients with obstructive sleep apnea hypopnea syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

WANG Shu ¹ , XIONG Jing ¹ , LIU Huanbing ¹ , YU Shaoqing ¹ , FANG Jiwei ¹ , FU Zhiyun ² ,  ZHANG Wei ²

1. Department of Geratology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P. R. China;
2. Department of Respiratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P. R. China;

Corresponding author：

ZHANG Wei, Email: zhangweiliuxin@163.com

Keywords：

Obstructive sleep apnea hypopnea syndrome; Osteoporosis; Bone mineral density; Sex hormone; Testosterone

DOI：

10.7507/1671-6205.201708060

Video：

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Objective To ananlyze the relationship between bone mineral density and sex hormone in male patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods The study recruited 88 male patients with OSAHS aged 45-60 years in our hospital from October 2014 to October 2016 as an OSAHS group, and 30 healthy subjects without OSAHS as a control group. The general information and PSG parameters were recorded, the bone metabolic markers and bone mineral density of lumbar spine 1-4 (L1-4) and femoral neck (Neck) were measured, and the expressions of serum sex hormone (E2, P, T, FSH, LH and PRL) were determined by chemical luminescence immunity analyzer. The differences in above indexes between two groups and their correlation with bone mineral density were analyzed. Results Smoking rate, drinking rate, neck circumference and body mass index (BMI) of the OSAHS group were significantly higher than those of the control group. Compared with the control group, beta crosslaps (β-CTX, a bone metabolic marker) was significantly higher [(0.53±0.14) ng/ml vs. (0.47±0.15) ng/ml], the bone mineral density of L1-4 and Neck was significantly lower [(0.92±0.12) g/cm² vs. (1.08±0.08) g/cm², (0.91±0.11) g/cm² vs. (1.06±0.13) g/cm²], and the serum testosterone was significantly lower in the OSAHS group [(267.32±89.56) ng/dlvs. (315.68±78.49) ng/dl] (all P<0.05). The result of Pearson correlation analysis showed that apnea hypopnea index (AHI) was negatively correlated with bone mineral density of L1-4 and Neck (bothP<0.001), lowest oxygen saturation (LSaO₂) and testosterone were positively correlated with bone mineral density of L1-4 and Neck (all P<0.01). Conclusions The risk of suffering from osteoporosis is higher in male OSAHS patients and it is closely related to the degree of hypoxia. The decrease of testosterone may be one of the mechanisms.

Citation： WANG Shu, XIONG Jing, LIU Huanbing, YU Shaoqing, FANG Jiwei, FU Zhiyun, ZHANG Wei. The relationship between sex hormone and bone mineral density in male patients with obstructive sleep apnea hypopnea syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(1): 55-58. doi: 10.7507/1671-6205.201708060 Copy

1.	韦凯, 郭树琴, 温伟生. 阻塞性睡眠呼吸障碍与全身多系统疾病关系的研究进展. 中国老年口腔医学杂志, 2016, 14(1): 54-57.
2.	Ceccato F, Bernkopf E, Scaroni C. Sleep apnea syndrome in endocrine clinics. J Endocrinol Invest, 2015, 38(8): 827-834.
3.	Chen YL, Weng SF, Shen YC, et al. Obstructive sleep apnea and risk of osteoporosis: a population based cohort study in Taiwan. J Clin Endocrin Metab, 2014, 99(7): 2441-2447.
4.	Uzkeser H, Yildirim K, Aktan B, et al. Bone mineral density in patients with obstructive sleep apnea syndrome. Sleep Breath, 2013, 17(1): 339-342.
5.	Terzi R, Yılmaz Z. Bone mineral density and changes in bone metabolism in patients with obstructive sleep apnea syndrome. J Bone Miner Metab, 2015, 24(1): 986-989.
6.	金常娥, 吴迪, 何正强, 等. 阻塞性睡眠呼吸暂停低通气综合征与骨质疏松症的相关性分析. 中国骨质疏松杂志, 2015, 21(1): 63-66.
7.	中华医学会呼吸病学分会睡眠呼吸障碍学组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011 修订版). 中华结核和呼吸杂志, 2012, 35(1): 9-12.
8.	Liguori C, Izzi F, Mercuri NB, Tarantino U, et al. Physical activity contradictorily affects bone mineral density in obstructive sleep apnea patients at different ages. Sleep Med, 2016, 11(29): 25-32.
9.	谷君, 权玉玲, 宁改君, 等. 阻塞性睡眠呼吸暂停低通气综合征患者骨密度的变化及意义. 中国临床医师杂志, 2016, 44(7): 25-27.
10.	张刘生, 李正芳, 刘英育, 等. 慢性间歇性低氧/复氧对大鼠骨代谢的影响. 中国骨质疏松杂志, 2015, 22(5): 536-539.
11.	易开君, 王帆, 王莲朋, 等. 慢性间歇性缺氧导致骨质疏松症的研究进展. 中国临床研究, 2017, 30(7): 995-998.
12.	LeBlanc ES, Nielson CM, Marshall LM, et al. The effects of serum testosterone, estradiol, and sex hormone binding globulin levels on fracture risk in older men. J Clin Endocrinol Metab, 2009, 94(9): 3337-3346.
13.	Cauley JA, Ewing SK, Taylor BC, et al. Sex steroid hormones in older men: longitudinal associations with 4.5-year change in hip bone mineral density--the osteoporotic fractures in men study. J Clin Endocrinol Metab, 2010, 95(9): 4314-4323.
14.	Erben RG, Eberle J, Stahr K, et a1. Androgen deficiency induces high turnover osteopenia in aged male rats: a sequential histomorphometric study. J Bone Miner Res, 2000, 15(6): 1085-1098.
15.	Tran TS, Center JR, Seibel MJ, et al. Relationship between serum testosterone and fracture risk in men: a comparison of RIA and LC-MS/MS. Clin Chem, 2015, 61(9): 1182-1190.
16.	宁欣. 老年阻塞性睡眠呼吸暂停患者血清肿瘤坏死因子水平的研究. 现代医药卫生, 2008, 24(12): 1771-1772.
17.	江涛源, 林其昌, 洪友志. 福州城镇男性阻塞性睡眠呼吸暂停低通气综合征患者睾酮水平研究. 国际呼吸杂志, 2011, 31(5): 355-358.
18.	Gizza G, Jonge L, Piaggi P, et al. Neck circumference is a predictor of metabolic syndrome and obstructive sleep apnea in short-sleeping obese men and women. Metab Syndr Relat Disoord, 2014, 12(4): 231-241.
19.	Derby CA, Zilber S, Brambilla D, et al. Body mass index, waist, circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Aging Study. Clin Endocrinol, 2006, 65(1): 125-131.
20.	Trummer H, Habermann H, Hass J, et al. Effect of cigarette smoke on spermatogenesis in rats. Urol J, 2007, 4(3): 159-163.
21.	李亮亮, 于德新, 谢栋栋, 等. 吸烟对雄性小鼠睾丸间质细胞、睾酮及精子数量的影响. 中国男科学杂志, 2015, 29(3): 23-28.
22.	de Souza Predes F, Monteiro JC, Matta SL, et al. Testicular histomorphometry and ultrastructure of rats treated with cadmium and ginkgo biloba. Biol Trace Elem Res, 2011, 140(3): 330-341.

1. 韦凯, 郭树琴, 温伟生. 阻塞性睡眠呼吸障碍与全身多系统疾病关系的研究进展. 中国老年口腔医学杂志, 2016, 14(1): 54-57.
2. Ceccato F, Bernkopf E, Scaroni C. Sleep apnea syndrome in endocrine clinics. J Endocrinol Invest, 2015, 38(8): 827-834.
3. Chen YL, Weng SF, Shen YC, et al. Obstructive sleep apnea and risk of osteoporosis: a population based cohort study in Taiwan. J Clin Endocrin Metab, 2014, 99(7): 2441-2447.
4. Uzkeser H, Yildirim K, Aktan B, et al. Bone mineral density in patients with obstructive sleep apnea syndrome. Sleep Breath, 2013, 17(1): 339-342.
5. Terzi R, Yılmaz Z. Bone mineral density and changes in bone metabolism in patients with obstructive sleep apnea syndrome. J Bone Miner Metab, 2015, 24(1): 986-989.
6. 金常娥, 吴迪, 何正强, 等. 阻塞性睡眠呼吸暂停低通气综合征与骨质疏松症的相关性分析. 中国骨质疏松杂志, 2015, 21(1): 63-66.
7. 中华医学会呼吸病学分会睡眠呼吸障碍学组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011 修订版). 中华结核和呼吸杂志, 2012, 35(1): 9-12.
8. Liguori C, Izzi F, Mercuri NB, Tarantino U, et al. Physical activity contradictorily affects bone mineral density in obstructive sleep apnea patients at different ages. Sleep Med, 2016, 11(29): 25-32.
9. 谷君, 权玉玲, 宁改君, 等. 阻塞性睡眠呼吸暂停低通气综合征患者骨密度的变化及意义. 中国临床医师杂志, 2016, 44(7): 25-27.
10. 张刘生, 李正芳, 刘英育, 等. 慢性间歇性低氧/复氧对大鼠骨代谢的影响. 中国骨质疏松杂志, 2015, 22(5): 536-539.
11. 易开君, 王帆, 王莲朋, 等. 慢性间歇性缺氧导致骨质疏松症的研究进展. 中国临床研究, 2017, 30(7): 995-998.
12. LeBlanc ES, Nielson CM, Marshall LM, et al. The effects of serum testosterone, estradiol, and sex hormone binding globulin levels on fracture risk in older men. J Clin Endocrinol Metab, 2009, 94(9): 3337-3346.
13. Cauley JA, Ewing SK, Taylor BC, et al. Sex steroid hormones in older men: longitudinal associations with 4.5-year change in hip bone mineral density--the osteoporotic fractures in men study. J Clin Endocrinol Metab, 2010, 95(9): 4314-4323.
14. Erben RG, Eberle J, Stahr K, et a1. Androgen deficiency induces high turnover osteopenia in aged male rats: a sequential histomorphometric study. J Bone Miner Res, 2000, 15(6): 1085-1098.
15. Tran TS, Center JR, Seibel MJ, et al. Relationship between serum testosterone and fracture risk in men: a comparison of RIA and LC-MS/MS. Clin Chem, 2015, 61(9): 1182-1190.
16. 宁欣. 老年阻塞性睡眠呼吸暂停患者血清肿瘤坏死因子水平的研究. 现代医药卫生, 2008, 24(12): 1771-1772.
17. 江涛源, 林其昌, 洪友志. 福州城镇男性阻塞性睡眠呼吸暂停低通气综合征患者睾酮水平研究. 国际呼吸杂志, 2011, 31(5): 355-358.
18. Gizza G, Jonge L, Piaggi P, et al. Neck circumference is a predictor of metabolic syndrome and obstructive sleep apnea in short-sleeping obese men and women. Metab Syndr Relat Disoord, 2014, 12(4): 231-241.
19. Derby CA, Zilber S, Brambilla D, et al. Body mass index, waist, circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Aging Study. Clin Endocrinol, 2006, 65(1): 125-131.
20. Trummer H, Habermann H, Hass J, et al. Effect of cigarette smoke on spermatogenesis in rats. Urol J, 2007, 4(3): 159-163.
21. 李亮亮, 于德新, 谢栋栋, 等. 吸烟对雄性小鼠睾丸间质细胞、睾酮及精子数量的影响. 中国男科学杂志, 2015, 29(3): 23-28.
22. de Souza Predes F, Monteiro JC, Matta SL, et al. Testicular histomorphometry and ultrastructure of rats treated with cadmium and ginkgo biloba. Biol Trace Elem Res, 2011, 140(3): 330-341.

Chinese Journal of Respiratory and Critical Care Medicine

The relationship between sex hormone and bone mineral density in male patients with obstructive sleep apnea hypopnea syndrome

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