The association of thyroid hormone level in patients with obstructive sleep apnea syndrome: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Xianqiang ^1,2 , AINIGEL Abramithi ^1,2 , YAO Xiaoguang ¹ , ZHU Qing ¹ ,  LI Nanfang ¹ , JIANG Wen ¹

1. Department of Hypertension, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Institute of Hypertension, Urumqi, 830001, P.R.China;
2. Postgraduate College of Xinjiang Medical University, Urumqi, 830001, P.R.China;

Corresponding?author：

LI Nanfang, Email: lnanfang2010@sina.com

Keywords：

Obstructive sleep apnea syndrome; Thyroid hormone; Meta-analysis; Case-control study

DOI：

10.7507/1672-2531.201610089

Video：

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ObjectiveTo systematically review the association between obstructive sleep apnea syndrome and levels of thyroid hormone.MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 6, 2016), Web of Science, VIP, CNKI, WanFang Data, CBM and the relevant conference abstracts and unpublished literatures from inception to June, 2016 to collect the case-control studies about the levels of thyroid hormones with OSAS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software.ResultsA total of 8 RCTs involving 1 519 patients were included. The results of meta-analysis showed that: there were no significant differences of levels of FT₃ between OSAS group and control group (mild: SMD=–0.01, 95%CI –0.21 to 0.20, P=0.93; moderate: SMD=0.15, 95%CI –0.34 to 0.64, P=0.55; severe: SMD=0.12, 95%CI –0.32 to 1.25, P=0.08). There were significant differences of levels of FT₄ between mild and moderate OSAS groups with control group (mild: SMD=–0.49, 95%CI –0.74 to –0.25, P<0.000 1; moderate: SMD=–0.86, 95%CI –1.69 to –0.02, P=0.04), but no significant difference in severe group (SMD=–1.06, 95%CI –2.16 to 0.03, P=0.06). There were no significant differences of levels of TSH between OSAS group and control group (mild: SMD=–0.03, 95%CI –0.13 to 0.20, P=0.69; moderate: SMD=–0.09, 95%CI –0.27 to –0.10, P=0.35; severe: SMD=–0.02, 95%CI –0.26 to –0.22, P=0.88).ConclusionsThe current evidence shows that, OSAS is associated with lower levels of FT₄. Due to the limited quality and quantity of included studies, the above results are needed to validate by more studies.

Citation： ZHANG Xianqiang, AINIGEL Abramithi, YAO Xiaoguang, ZHU Qing, LI Nanfang, JIANG Wen. The association of thyroid hormone level in patients with obstructive sleep apnea syndrome: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(8): 921-927. doi: 10.7507/1672-2531.201610089 Copy

1.	阻塞性睡眠呼吸暫停低通氣綜合征診治指南寫作. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南(基層版). 中華全科醫師雜志, 2015, 14(7): 398-405.
2.	Pepperell JC, Ramdassinghdow S, Crosthwaite N, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnea: a randomized parallel trial. Lancet, 2002, 359(9302): 204-210.
3.	Stand A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analysis. Eur J Epidemiol, 2010, 25(9): 603-605.
4.	朱建華, 劉同賞, 王愛英. 阻塞性睡眠呼吸暫停低通氣綜合征與甲狀腺功能的相關性. 中國綜合臨床, 2015, 31(8): 715-717.
5.	陳可強. 阻塞性睡眠呼吸暫停低通氣綜合征患者血清甲狀腺激素、皮質醇水平分析. 福州: 福建中醫藥大學, 2015.
6.	孫超. 阻塞性睡眠呼吸暫停與甲狀腺疾病的相關性研究. 烏魯木齊: 新疆醫科大學, 2015.
7.	李樹奇, 林其昌. 阻塞性睡眠呼吸暫停綜合征患者甲狀腺激素水平的變化. 國際呼吸雜志, 2011, 31(13): 1004-1007.
8.	何志紅, 高英, 彭少舫, 等. 肥胖癥合并 OSAHS 時頸圍與甲狀腺素的相關性研究. 河北醫藥, 2009, 31(22): 3079-3080.
9.	郭彥紅. OSAS對甲狀腺功能的影響及其與細胞因子 IL-2、IL-6 關系的研究. 西安: 第四軍醫大學, 2001.
10.	Mete T, Yalcin Y, Berker D, et al. Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine, 2013, 44(3): 723-728.
11.	Bozkurt NC, Karbek B, Cakal E, et al. The association between severity of obstructive sleep apnea and prevalence of Hashimoto's thyroiditis. Endocr J, 2012, 59(11): 981-988.
12.	Kapur VK. Obstructive sleep apnea: diagnosis, epidemiology, and economics. Respir Care, 2010, 55(9): 1155-1167.
13.	Lin CC, Tsan KW, Chen PJ. The relationship between sleep apnea syndrome and hypothyroidism. Chest, 1992, 102(6): 1663-1667.
14.	Zhang M, Zhang W, Jin T, et al. Role of hypothyroidism in obstructive sleep apnea: a meta-analysis. Curr Med Res Opin, 2016, 32(6): 1-23.
15.	Devdhar M, Ousman YH, Burman KD. Hypothyroidism. Endocrinol Metab Clin North Am, 2007, 36(3): 595-615.
16.	Attal P, Chanson P. Endocrine aspects of obstructive sleep apnea. J Clin Endocrinol Metab, 2010, 95(2): 483-495.
17.	Custro N, Scafidi V, Costanzo G, et al. Prospective study on thyroid function anomalies in severely ill patients. Ann Ital Med Int, 1992, 7(1): 13-18.
18.	Bahammam SA, Sharif MM, Jammah AA, et al. Prevalence of thyroid disease in patients with obstructive sleep apnea. Respir Med, 2011, 105(11): 1755-1760.
19.	Jauchchara K, Schmid SM, Hallschmid M, et al. Pituitary-gonadal and pituitary–thyroid axis hormone concentrations before and during a hypoglycemic clamp after sleep deprivation in healthy men. PloS One, 2013, 8(1): e54209.

1. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南寫作. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南(基層版). 中華全科醫師雜志, 2015, 14(7): 398-405.
2. Pepperell JC, Ramdassinghdow S, Crosthwaite N, et al. Ambulatory blood pressure after therapeutic and subtherapeutic nasal continuous positive airway pressure for obstructive sleep apnea: a randomized parallel trial. Lancet, 2002, 359(9302): 204-210.
3. Stand A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analysis. Eur J Epidemiol, 2010, 25(9): 603-605.
4. 朱建華, 劉同賞, 王愛英. 阻塞性睡眠呼吸暫停低通氣綜合征與甲狀腺功能的相關性. 中國綜合臨床, 2015, 31(8): 715-717.
5. 陳可強. 阻塞性睡眠呼吸暫停低通氣綜合征患者血清甲狀腺激素、皮質醇水平分析. 福州: 福建中醫藥大學, 2015.
6. 孫超. 阻塞性睡眠呼吸暫停與甲狀腺疾病的相關性研究. 烏魯木齊: 新疆醫科大學, 2015.
7. 李樹奇, 林其昌. 阻塞性睡眠呼吸暫停綜合征患者甲狀腺激素水平的變化. 國際呼吸雜志, 2011, 31(13): 1004-1007.
8. 何志紅, 高英, 彭少舫, 等. 肥胖癥合并 OSAHS 時頸圍與甲狀腺素的相關性研究. 河北醫藥, 2009, 31(22): 3079-3080.
9. 郭彥紅. OSAS對甲狀腺功能的影響及其與細胞因子 IL-2、IL-6 關系的研究. 西安: 第四軍醫大學, 2001.
10. Mete T, Yalcin Y, Berker D, et al. Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine, 2013, 44(3): 723-728.
11. Bozkurt NC, Karbek B, Cakal E, et al. The association between severity of obstructive sleep apnea and prevalence of Hashimoto's thyroiditis. Endocr J, 2012, 59(11): 981-988.
12. Kapur VK. Obstructive sleep apnea: diagnosis, epidemiology, and economics. Respir Care, 2010, 55(9): 1155-1167.
13. Lin CC, Tsan KW, Chen PJ. The relationship between sleep apnea syndrome and hypothyroidism. Chest, 1992, 102(6): 1663-1667.
14. Zhang M, Zhang W, Jin T, et al. Role of hypothyroidism in obstructive sleep apnea: a meta-analysis. Curr Med Res Opin, 2016, 32(6): 1-23.
15. Devdhar M, Ousman YH, Burman KD. Hypothyroidism. Endocrinol Metab Clin North Am, 2007, 36(3): 595-615.
16. Attal P, Chanson P. Endocrine aspects of obstructive sleep apnea. J Clin Endocrinol Metab, 2010, 95(2): 483-495.
17. Custro N, Scafidi V, Costanzo G, et al. Prospective study on thyroid function anomalies in severely ill patients. Ann Ital Med Int, 1992, 7(1): 13-18.
18. Bahammam SA, Sharif MM, Jammah AA, et al. Prevalence of thyroid disease in patients with obstructive sleep apnea. Respir Med, 2011, 105(11): 1755-1760.
19. Jauchchara K, Schmid SM, Hallschmid M, et al. Pituitary-gonadal and pituitary–thyroid axis hormone concentrations before and during a hypoglycemic clamp after sleep deprivation in healthy men. PloS One, 2013, 8(1): e54209.

Chinese Journal of Evidence-Based Medicine

The association of thyroid hormone level in patients with obstructive sleep apnea syndrome: a meta-analysis

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