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| 阻塞性睡眠呼吸暂停低通气综合征患者氧化应激、性激素水平与骨密度的相关性研究 |
| The relationship between oxidative stress, sex hormone level, and bone mineral density in patients with obstructive sleep apnea hypopnea syndrome |
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| DOI：10.3969/j.issn.1006-7108.2021.07.010 |
| 中文关键词: 阻塞性睡眠呼吸暂停低通气综合征 骨密度 氧化应激 睾酮 |
| 英文关键词:obstructive sleep apnea hypopnea syndrome osteoporosis oxidative stress testosterone |
| 基金项目:北京市科学技术委员会课题（Z171100000417054） |
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| 中文摘要: |
| 目的 探讨男性阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）患者骨密度改变以及与氧化应激、性激素水平变化的相关性。方法 通过多导睡眠（polysomnography，PSG）监测入选48例男性OSAHS患者，其中轻中度组19例，重度组29例，同时选择经PSG监测排除OSAHS的男性对照组20例。受试者填写Epworth嗜睡量表(Epworth sleepiness scale，ESS)问卷；使用双能X线吸收测定法（dual energy X-ray absorptiometry，DEXA）测定腰椎前后位腰1至腰4、股骨颈面积骨密度（bone mineral density，BMD）和T值。测定外周血以下指标的水平并进行相关性分析：总抗氧化能力（total antioxidant capacity，TA0C）、活性氧（reactive oxygen species，ROS）、血清睾酮(testosterone，T)、血清钙、磷。结果 （1）与对照组相比，OSAHS组股骨颈和腰椎BMD及T值减低，两组比较有显著性差异（P＜0.05）。（2）OSAHS组与对照组比较TAOC、ROS、睾酮水平下降，两组间有显著性差异（P＜0.05）。（3）OSAHS轻中度组和重度组股骨颈和腰椎BMD及T值比较均无显著性差异（P＞0.05），轻中度组和重度组间睾酮、TAOC、ROS比较均无显著性差异（P＞0.05）（4）患者组睾酮水平与TAOC呈正相关（r=0.436，P＜0.01），与ROS呈负相关（r=-0.471，P＜0.05）。睾酮水平与股骨颈和腰椎BMD呈正相关（r=0.357、0.396，P＜0.01）。结论 OSAHS患者存在氧化抗氧化失衡，与氧化应激和睾酮水平下降有一定关系，性激素水平下降可增加患者骨质疏松发生的风险。 |
| 英文摘要: |
| Objective To study the changes of oxidative stress, sex hormone level, and bone mineral density in male patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Forty-eight male patients with OSAHS, confirmed with polysomnography (PSG) study, were enrolled. The patients were divided into mild-moderate group (n=19) and severe group (n=29). Twenty male subjects who were confirmed as not having OSAHS served as the controls. Bone mineral density (BMD) of the lumbar spine and femoral neck in the subjects was assessed using dual-energy X-ray absorptiometry (DEXA). Blood samples were collected from all the subjects for measurement of total antioxidant capacity (TAOC), reactive oxygen species (ROS), calcium, phosphorus, and testosterone. Results BMD and T-score of the femoral neck and the lumbar spine were significantly lower in OSAHS patients than those in control group (P<0.05). The serum levels of TAOC, ROS, and testosterone decreased significantly in the OSAHS group compared to those in the control group (P<0.05). None of these parameters (BMD,T-score, TAOC, and testosterone) showed significant difference between patients with mild-moderate and severe OSAHS. Correlation analysis showed that the TAOC level was positively correlated with testosterone. There was negatively correlation between testosterone and ROS in the OSAHS group (r=0.436, -0.471, P<0.05). There was positively correlation between testosterone and BMD or T-scores (r=0.357, 0.396, P＜0.01). Conclusion In OSAHS patients, the imbalance between oxidation and antioxidation exists. Oxidative stress is related to the decrease of testosterone level. The decease of sex hormone increases the risk of the occurrence of osteoporosis. |
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