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Library (Issue 6, 2016), Web of Science, VIP, CNKI, WanFang Data, CBM and the relevant conference abstracts and unpublished literatures from inception to June, 2016 to collect the case-control studies about the levels of thyroid hormones with OSAS.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.	阻塞性睡眠呼吸暂停低通气综合征诊治指南写作. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版). 中华全科医师杂志, 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.	朱建华, 刘同赏, 王爱英. 阻塞性睡眠呼吸暂停低通气综合征与甲状腺功能的相关性. 中国综合临床, 2015, 31(8): 715-717.
5.	陈可强. 阻塞性睡眠呼吸暂停低通气综合征患者血清甲状腺激素、皮质醇水平分析. 福州: 福建中医药大学, 2015.
6.	孙超. 阻塞性睡眠呼吸暂停与甲状腺疾病的相关性研究. 乌鲁木齐: 新疆医科大学, 2015.
7.	李树奇, 林其昌. 阻塞性睡眠呼吸暂停综合征患者甲状腺激素水平的变化. 国际呼吸杂志, 2011, 31(13): 1004-1007.
8.	何志红, 高英, 彭少舫, 等. 肥胖症合并 OSAHS 时颈围与甲状腺素的相关性研究. 河北医药, 2009, 31(22): 3079-3080.
9.	郭彦红. OSAS对甲状腺功能的影响及其与细胞因子 IL-2、IL-6 关系的研究. 西安: 第四军医大学, 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. 阻塞性睡眠呼吸暂停低通气综合征诊治指南写作. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版). 中华全科医师杂志, 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. 朱建华, 刘同赏, 王爱英. 阻塞性睡眠呼吸暂停低通气综合征与甲状腺功能的相关性. 中国综合临床, 2015, 31(8): 715-717.
5. 陈可强. 阻塞性睡眠呼吸暂停低通气综合征患者血清甲状腺激素、皮质醇水平分析. 福州: 福建中医药大学, 2015.
6. 孙超. 阻塞性睡眠呼吸暂停与甲状腺疾病的相关性研究. 乌鲁木齐: 新疆医科大学, 2015.
7. 李树奇, 林其昌. 阻塞性睡眠呼吸暂停综合征患者甲状腺激素水平的变化. 国际呼吸杂志, 2011, 31(13): 1004-1007.
8. 何志红, 高英, 彭少舫, 等. 肥胖症合并 OSAHS 时颈围与甲状腺素的相关性研究. 河北医药, 2009, 31(22): 3079-3080.
9. 郭彦红. OSAS对甲状腺功能的影响及其与细胞因子 IL-2、IL-6 关系的研究. 西安: 第四军医大学, 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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