Lack of associations between thyroid dysfunction and obstructive sleep apnea-hypopnea syndrome: A meta-analysis.

Juan Xiong, Hongxia Hu, Yuanyuan Huang, Jiexi Zhang, Jie He

Journal: Medicine 2023;102(49):e36531

PMID: 38065875

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Plain Language Summary

Obstructive sleep apnoea-hypopnea syndrome (OSAHS) is a common sleep disorder characterised by repeated episodes of partial or complete obstruction of the upper airway during sleep. Thyroid dysfunction, including hypothyroidism and hyperthyroidism, has been suggested as a potential contributing factor to OSAHS. The primary aim of this study was to evaluate the association between thyroid dysfunction and OSAHS through a comprehensive meta-analysis of existing research. This study was a meta-analysis of twenty-three articles, encompassing 1000 individuals with OSAHS and 1000 healthy individuals. Results showed that: - the prevalence of subclinical hypothyroidism, hypothyroidism, and hyperthyroidism in OSAHS patients was found to be 8%, 6%, and 2%. - OSAHS patients did not exhibit significant alterations in several key thyroid function indicators when compared to healthy non-OSAHS individuals, except for free-thyroxine (FT4) and total thyroxine. - no significant correlation was found between Apnea-Hypopnea Index and serum thyroid-stimulating hormone, free triiodothyronine, and FT4. Authors concluded that there is no significant association between thyroid dysfunction and OSAHS. These findings suggest that thyroid dysfunction may not be a contributing factor to the development or severity of OSAHS.

Abstract

BACKGROUND

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a comprehensive syndrome with endocrine and metabolic complications. This review aims to explore the correlation between thyroid hormone levels and the severity of OSAHS in patients.

METHODS

The protocol for this meta-analysis has been registered on PROSPERO. Searches were carried out from the inception of the databases to July 18, 2023, utilizing 6 databases (PubMed, CNKI, EMBASE, Web of Science, Cochrane Library, China Biology Medicine, and Wanfang). Standardized mean difference (SMD) and correlation coefficients were used as the effect size measures. Additionally, random effects or fixed effects models were used for pooled analysis. Moreover, data were statistically evaluated with the help of STATA 11.0 and R 4.1.3.

RESULTS

This study included 23 articles that satisfied the pre-defined criteria. The prevalence of hypothyroidism and subclinical hypothyroidism in OSAHS patients was 6% and 8%, whereas hyperthyroidism had a prevalence of 2%. Moreover, thyroid hormone levels in OSAHS individuals exhibited no significant difference relative to healthy subjects. Subgroup analysis based on disease severity also established no significant changes in thyroid hormone levels between OSAHS individuals and controls. There was no significant correlation between the Apnea-Hypopnea Index (AHI) and free triiodothyronine (FT3), serum thyroid stimulating hormone (TSH), and free thyroxine (FT4) levels.

CONCLUSION

The prevalence of thyroid dysfunction is relatively low in OSAHS individuals. Thyroid hormone levels show no significant difference between OSAHS patients and healthy subjects. Furthermore, there is no significant correlation between AHI and serum TSH, FT3, and FT4 levels. Based on existing data, the relationship between OSAHS and thyroid function remains controversial, and further in-depth research is warranted to validate the connection and elucidate the underlying mechanisms.

Address: Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.; Emergency Department, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.; Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.; Department of Obstetrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.; Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.; Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.; Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China.

DOI: 10.1097/MD.0000000000036531