Neuroendocrine Alterations in Obese Patients with Sleep Apnea Syndrome

Lanfranco, Fabio; Motta, Giovanna; Minetto, Marco Alessandro; Baldi, Matteo; Balbo, M.; Ghigo, Ezio; Arvat, Emanuela; Maccario, Mauro

doi:10.1155/2010/474518

Cited by 66 publications

(49 citation statements)

References 117 publications

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“…No presente estudo, foi encontrada a prevalência de 16,2% (21/130) de hipotireoidismo em pacientes com SAOS sendo a maioria do gênero masculino e 10% (7/70) de hipotireoidismo em pacientes sem SAOS sendo todos (100%) do gênero feminino. A revisão da literatura revelou que, em avaliações de pacientes com critérios de inclusão e metodologia semelhantes aos deste estudo, foi obtida a prevalência de hipotireoidismo em pacientes diagnosticados com SAOS que variou de 0,9% (5/542) (23) , 2,4% (93/124) (24) , 2,9% (3/103) (25) a 11,5%(9/78) (26) -e, em apenas um desses estudos, foi relatada a prevalência de 0,7% (1/135) (25) de hipotireoidismo nos pacientes sem SAOS. Mesmo assim, as prevalências encontradas foram inferiores as do presente estudo, independentemente da diferença no tamanho das amostras.…”

Section: Discussionunclassified

Prevalência De Hipotireoidismo Em Pacientes Com Queixas De Distúrbios Respiratórios Relacionados Ao Sono

Bortoluzzi¹,

Carreira²,

Oliveira³

et al. 2016

ACS

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Conflito de interesses: NãoContribuição dos autores: TBB concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. YCVA concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. ACO concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. ICAS concepção e planejamento do projeto de pesquisa, obtenção ou análise/ interpretação dos dados, redação e revisão crítica. VBP concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. FDM concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. p=0,3258). Conclusão: A prevalência de hipotireoidismo clínico na população estudada foi maior que a determinada na população geral. Pacientes com sinais e sintomas similares tanto ao hipotireoidismo como a síndrome da apneia obstrutiva do sono podem se beneficiar da dosagem hormonal tireoidiana.Descritores: Síndromes da Apneia do Sono; Hipotireoidismo; Identidade de Gênero. Abstract Introduction:The obstructive sleep apnea syndrome is one of the most complex sleep disorders. The association between hypothyroidism and obstructive sleep apnea syndrome has been the focus of research due to the similarity of symptoms of both disorders. Objective: Determine the prevalence of hypothyroidism in patients complaining of sleep-related breathing disorders. Material and Methods: Two hundred reports from patients of both genders who were referred to first appointment at the Sleep Apnea Clinic of a tertiary center between 2013 and 2014, were revised. The following data were collected: age at time of polysomnography, serum concentration of free thyroxine (T4) and thyroid-stimulating hormone (TSH), body mass index (BMI) and apnea/hypopnea index (AHI). A retrospective cross-sectional case study. Results: A prevalence of 16.2% (21/130) of hypothyroidism in patients with obstructive sleep apnea syndrome was found and most of them were male, and 10% (7/70) of hypothyroidism in patients without obstructive sleep apnea syndrome and all of them (100%) were female (OR-1.734; CI95%-0.6979-4.308; χ 2 -0.96565; p=0.3258). Conclusion:The prevalence of clinical hypothyroidism in this population was higher than that determined in the general population. Patients with similar signs and symptoms of both hypothyroidism and obstructive sleep apnea syndrome might benefit from thyroid hormone tests.

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Section: Discussionunclassified

Prevalência De Hipotireoidismo Em Pacientes Com Queixas De Distúrbios Respiratórios Relacionados Ao Sono

Bortoluzzi¹,

Carreira²,

Oliveira³

et al. 2016

ACS

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confidence: 91%

“…Obese patients with OSAS show alterations in the GH/IGF-I axis function, PRL secretion, HPA axis and gonadal axis activity. Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated by some authors, whereas a normal thyroid activity has been described by others [5,6].The study by Mete and colleagues published on Endocrine in April 2013 examined the relationship between OSAS and thyroid disease. Functional and ultrasonographic examination of the thyroid gland was performed in 150 polysomnographically diagnosed OSAS patients and in 32 control subjects.…”

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confidence: 97%

“…It is strongly associated with obesity and is characterized by several endocrine and metabolic abnormalities that are frequently more marked than those in obese patients without OSAS, suggesting that factors other than obesity per se have a role in this clinical condition [6]. Obese patients with OSAS show alterations in the GH/IGF-I axis function, PRL secretion, HPA axis and gonadal axis activity.…”

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Sleep apnea syndrome and hypothyroidism

Lanfranco

2013

Endocrine

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Obstructive sleep apnea syndrome (OSAS) is a serious, prevalent condition that has significant mortality and morbidity when untreated. It is strongly associated with obesity and is characterized by several endocrine and metabolic abnormalities that are frequently more marked than those in obese patients without OSAS, suggesting that factors other than obesity per se have a role in this clinical condition [6]. Obese patients with OSAS show alterations in the GH/IGF-I axis function, PRL secretion, HPA axis and gonadal axis activity. Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated by some authors, whereas a normal thyroid activity has been described by others [5,6].The study by Mete and colleagues published on Endocrine in April 2013 examined the relationship between OSAS and thyroid disease. Functional and ultrasonographic examination of the thyroid gland was performed in 150 polysomnographically diagnosed OSAS patients and in 32 control subjects. Aim of the study was to evaluate both thyroid function and thyroid nodule frequency and parenchyma heterogenecity in OSAS patients. The morphologic evaluation of the thyroid gland is peculiar of this study in comparison to other investigations. In fact, regardless of hypothyroidism, large goiters alone can cause pharynx occlusion and thus OSAS. The authors did not find any difference in prevalence of hypothyroidism, numbers of nodules, and parenchyma heterogenecity determined by ultrasound, between OSAS subgroups and controls. Thus this study did not reveal any relationship between OSAS and thyroid disease. The authors concluded that long-term follow-up studies are needed to establish the possible significance of routine evaluation of OSAS patients for thyroid disease [9].As a matter of fact, the incidence of thyroid deficiency states in patients with OSAS is not clearly known, thus the opportunity to evaluate thyroid function in all patients with the syndrome is still debated.It is well known that OSAS and hypothyroidism have several common signs that create a significant risk of undiagnosed hypothyroidism in OSAS. On the other hand, the suspect of sleep apnea in hypothyroid patients, especially when obese and with persistent sleep-disordered breathing during appropriate replacement therapy, should be taken into account.Endocrinologists and professionals dealing with sleep disturbances and OSAS should bear in mind that hypothyroidism may cause OSAS and that OSAS may be linked to (or even cause) hypothyroidism.A link between hypothyroidism and OSAS is suggested by the high prevalence of sleep apnea among hypothyroid patients, particularly in rare myxedematous cases [3,7]. The increased prevalence of OSAS appears to be related to obesity and male sex rather than to hypothyroidism per se, although decreased ventilatory responses, extravasation of albumin, and mucopolysaccharides in the tissues of the upper airway and hypothyroid myopathy have been suggested as possible contributing factors for OSAS in hypothyroidism [3]. Moreover, co...

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“…Comorbidity of systemic hypertension, central obesity, insulin resistance which occur in metabolic syndrome (MS) or diabetes mellitus (DM), and hyperlipidaemia had been defined as syndrome X [1,2]. On the other hand, obstructive sleep apnea/hypopnea syndrome (OSAHS) is a condition characterized by intermittent, total or partial sudden collapse of the respiratory pathway, associated with hypoxia and snoring during sleep.…”

Section: Introductionmentioning

confidence: 99%

Sleep and Polysomnographic Alterations in Patients with Syndrome Z

et al. 2017

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Purpose Syndrome Z is the association of obstructive sleep apnea/hypopnea syndrome (OSAHS), vascular and metabolic risk factors. Our objective was to describe if there are sleep architecture (SA) alterations in polysomnography (PSG) recordings in patients with syndrome Z. Methods We performed PSG recordings in subjects with syndrome Z, a group of patients with OSAHS only, and a healthy control group. Comparison of SA parameters between groups controlling for confounding variables was performed. Results We observed no difference in mean of age, but a higher male percentage was observed in the OSAHS group. Body mass index and Epworth sleepiness scale means were significantly higher in patients with syndrome Z than of the other groups. Patients with syndrome Z exhibited lower scores of: total sleep time, sleep efficiency, oxygen saturation, maximum oxygen desaturation; and higher scores in: awake time, sleep in stage N1, apnea-hypopnea index, number of obstructive and snore events, heart rate, and electroencephalographic activations. Conclusion Patients with syndrome Z presented higher amount of SA alterations when compared with patients with OSAHS and control subjects.

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Neuroendocrine Alterations in Obese Patients with Sleep Apnea Syndrome

Cited by 66 publications

References 117 publications

Prevalência De Hipotireoidismo Em Pacientes Com Queixas De Distúrbios Respiratórios Relacionados Ao Sono

Prevalência De Hipotireoidismo Em Pacientes Com Queixas De Distúrbios Respiratórios Relacionados Ao Sono

Sleep apnea syndrome and hypothyroidism

Sleep and Polysomnographic Alterations in Patients with Syndrome Z

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