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.	韋凱, 郭樹琴, 溫偉生. 阻塞性睡眠呼吸障礙與全身多系統疾病關系的研究進展. 中國老年口腔醫學雜志, 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, Y?lmaz 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, 吳迪, 何正強, 等. 阻塞性睡眠呼吸暫停低通氣綜合征與骨質疏松癥的相關性分析. 中國骨質疏松雜志, 2015, 21(1): 63-66.
7.	中華醫學會呼吸病學分會睡眠呼吸障礙學組. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南(2011 修訂版). 中華結核和呼吸雜志, 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, 權玉玲, 寧改君, 等. 阻塞性睡眠呼吸暫停低通氣綜合征患者骨密度的變化及意義. 中國臨床醫師雜志, 2016, 44(7): 25-27.
10.	張劉生, 李正芳, 劉英育, 等. 慢性間歇性低氧/復氧對大鼠骨代謝的影響. 中國骨質疏松雜志, 2015, 22(5): 536-539.
11.	易開君, 王帆, 王蓮朋, 等. 慢性間歇性缺氧導致骨質疏松癥的研究進展. 中國臨床研究, 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.	寧欣. 老年阻塞性睡眠呼吸暫停患者血清腫瘤壞死因子水平的研究. 現代醫藥衛生, 2008, 24(12): 1771-1772.
17.	江濤源, 林其昌, 洪友志. 福州城鎮男性阻塞性睡眠呼吸暫停低通氣綜合征患者睪酮水平研究. 國際呼吸雜志, 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, 謝棟棟, 等. 吸煙對雄性小鼠睪丸間質細胞、睪酮及精子數量的影響. 中國男科學雜志, 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. 韋凱, 郭樹琴, 溫偉生. 阻塞性睡眠呼吸障礙與全身多系統疾病關系的研究進展. 中國老年口腔醫學雜志, 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, Y?lmaz 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, 吳迪, 何正強, 等. 阻塞性睡眠呼吸暫停低通氣綜合征與骨質疏松癥的相關性分析. 中國骨質疏松雜志, 2015, 21(1): 63-66.
7. 中華醫學會呼吸病學分會睡眠呼吸障礙學組. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南(2011 修訂版). 中華結核和呼吸雜志, 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, 權玉玲, 寧改君, 等. 阻塞性睡眠呼吸暫停低通氣綜合征患者骨密度的變化及意義. 中國臨床醫師雜志, 2016, 44(7): 25-27.
10. 張劉生, 李正芳, 劉英育, 等. 慢性間歇性低氧/復氧對大鼠骨代謝的影響. 中國骨質疏松雜志, 2015, 22(5): 536-539.
11. 易開君, 王帆, 王蓮朋, 等. 慢性間歇性缺氧導致骨質疏松癥的研究進展. 中國臨床研究, 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. 寧欣. 老年阻塞性睡眠呼吸暫停患者血清腫瘤壞死因子水平的研究. 現代醫藥衛生, 2008, 24(12): 1771-1772.
17. 江濤源, 林其昌, 洪友志. 福州城鎮男性阻塞性睡眠呼吸暫停低通氣綜合征患者睪酮水平研究. 國際呼吸雜志, 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, 謝棟棟, 等. 吸煙對雄性小鼠睪丸間質細胞、睪酮及精子數量的影響. 中國男科學雜志, 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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