Mechanism of obesity influencing thyroid function in patients with
obstructive sleep apnea hypopnea syndrome

doi:10.3760/cma.j.issn.1007-1245.2022.01.018

Abstract

Abstract: Obstructive sleep apnea hypopnea syndrome (OSAHS), also known as obstructive sleep apnea hypopnea syndrome, is a common sleep disorder in clinical medicine. According to relevant research reports, obesity is the highest risk factor for OSAHS. The relationship between the disease and thyroid function is not very clear, but some patients with OSAHS have hypothyroidism at the same time. Some scholars believe that this is not different from the incidence of hypothyroidism in the general population. At the same time, some scholars believe that obese patients with OSAHS and children with OSAHS have high risk of hypothyroidism. At present, the influence mechanism of obesity on thyroid function in OSAHS patients is still unclear. OSAHS patients are prone to recurrent apnea, hypoventilation, and micro arousal during sleep, leading to hypoxia. Obesity aggravates hypoxia and causes metabolic disorder, insulin resistance, and leptin, adiponectin, and functional changes. The change of vitamin D level can cause the change of thyroid function. Abnormal nerve regulation and inflammatory reaction can cause the change of thyroid function. In addition, obesity itself can also lead to changes in thyroid function. This article explores the mechanism of obesity on thyroid function in patients with OSAHS.

Key words: Obstructive sleep apnea hypopnea syndrome, Obesity, Thyroid function

摘要： 阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）属于临床医学中常见的睡眠病症，从相关研究报道来看，肥胖对该疾病的危险性是最高的。而该疾病与甲状腺功能之间的联系还不是十分明确，但是OSAHS患者中有一部分同时存在甲状腺功能减退情况，有学者认为这与普通人群甲状腺功能减退发生概率相差不大，同时也有学者认为OSAHS伴有肥胖患者、儿童OSAHS的甲状腺功能减退发生风险更高。目前，OSAHS患者肥胖对甲状腺功能的影响机制尚不清楚，可能一方面由于OSAHS患者在睡眠过程中容易反复出现呼吸暂停情况、低通气及微觉醒导致低氧，肥胖加重低氧，导致体内代谢紊乱，胰岛素抵抗、瘦素、脂联素等水平及功能变化、维生素D水平变化引起甲状腺功能改变，同时异常神经调节、炎性反应等亦可引起甲状腺功能改变；另外，肥胖本身也可导致甲状腺功能改变。本文探讨肥胖对OSAHS患者甲状腺功能影响机制。

关键词: 阻塞性睡眠呼吸暂停低通气综合征, 肥胖, 甲状腺功能

Zhang Huaqin, Zheng Yanwen, Wu Haiyan. Mechanism of obesity influencing thyroid function in patients with obstructive sleep apnea hypopnea syndrome[J]. International Medicine and Health Guidance News, 2022, 28(1): 75-78.

章华沁, 郑艳文, 邬海燕.

肥胖对OSAHS患者甲状腺功能影响机制的研究进展 [J]. 国际医药卫生导报, 2022, 28(1): 75-78.

References

[1] 中国医师协会睡眠医学专业委员会.成人阻塞性睡眠呼吸暂停多学科诊疗指南[J].中华医学杂志,2018,98(24):1902-1914.DOI:10.3760/cma.j.issn.0376-2491.2018. 24.003.

[2] Peromaa-Haavisto P, Tuomilehto H, Kössi J, et al. Obstructive sleep apnea: the effect of bariatric surgery after 12 months. A prospective multicenter trial[J]. Sleep Med, 2017,35:85-90. DOI: 10.1016/j.sleep.2016.12.017.

[3] Carneiro G, Zanella MT. Obesity metabolic and hormonal disorders associated with obstructive sleep apnea and their impact on the risk of cardiovascular events[J]. Metabolism, 2018,84:76-84. DOI: 10.1016/j.metabol. 2018.03.008.

[4] Lacedonia D, Carpagnano GE, Patricelli G, et al. Prevalence of comorbidities in patients with obstructive sleep apnea syndrome, overlap syndrome and obesity hypoventilation syndrome[J]. Clin Respir J, 2018,12(5):1905-1911. DOI: 10.1111/crj.12754.

[5] Sriphrapradang C, Pinyopodjanard S, Suntornlohanakul O,et al. Lack of associations between thyroid function and obstructive sleep apnea severity in adults with prediabetes and diabetes mellitus[J]. Sleep Breath,2019,23(3):963-967. DOI: 10.1007/s11325-018-1756-x.

[6] Bielicki P, Przybyłowski T, Kumor M,et al. Thyroid hormone levels and TSH activity in patients with obstructive sleep apnea syndrome[J]. Adv Exp Med Biol, 2016,878:67-71. DOI: 10.1007/5584_2015_180.

[7] Patinkin ZW, Feinn R, Santos M. Metabolic consequences of obstructive sleep apnea in adolescents with obesity: a systematic literature review and meta-analysis[J]. Child Obes, 2017,13(2):102-110. DOI: 10.1089/chi.2016.0248.

[8] Jeong JI, Gu S, Cho J, et al. Impact of gender and sleep position on relationships between anthropometric parameters and obstructive sleep apnea syndrome[J]. Sleep Breath, 2017,21(2):535-541. DOI: 10.1007/s11325-016-1413-1.

[9] Sahin M, Demircioglu D, Oguz A, et al. Does insulin resistance increase thyroid volume in patients with polycystic ovary syndrome?[J]. Arch Endocrinol Metab, 2017 ,61(2):145-151. DOI: 10.1590/2359-3997000000225.

[10] Pamuk AE, Süslü AE, Yalçınkaya A, et al. The serum leptin level in non-obese patients with obstructive sleep apnea[J]. Auris Nasus Larynx,2018,45(4):796-800. DOI: 10.1016/j.anl.2017.11.009.

[11] Imayama I, Prasad B. Role of leptin in obstructive sleep apnea[J]. Ann Am Thorac Soc, 2017,14(11):1607-1621. DOI: 10.1513/AnnalsATS.201702-181FR.

[12] Witkowska-Sędek E, Kucharska A, Rumińska M, et al. Thyroid dysfunction in obese and overweight children[J]. Endokrynol Pol, 2017;68(1):54-60. DOI: 10.5603/EP.2017.0007.

[13] Lozanov LB, Gorcheva D, Lozanov BS, et al. Role of thyroid deficiency on adiponectin, leptin, and metabolic status in visceral obesity: a cross-sectional study[J]. Horm Metab Res, 2017,49(9):667-672. DOI: 10.1055/s-0043-115532.

[14] Plesner JL, Dahl M, Fonvig CE, et al. Obesity is associated with vitamin D deficiency in Danish children and adolescents[J]. J Pediatr Endocrinol Metab, 2018 ,31(1):53-61. DOI: 10.1515/jpem-2017-0246.

[15] Kerley CP, Hutchinson K, Bolger K, et al. Serum vitamin D is significantly inversely associated with disease severity in caucasian adults with obstructive sleep apnea syndrome[J]. Sleep,2016,39(2):293-300. DOI: 10.5665/sleep.5430.

[16] Liguori C, Romigi A, Izzi F, et al. Continuous positive airway pressure treatment increases serum vitamin D levels in male patients with obstructive sleep apnea[J]. J Clin Sleep Med, 2015,11(6):603-607. DOI: 10.5664/jcsm.4766.

[17] Planck T, Shahida B, Malm J, et al. Vitamin D in graves disease: levels, correlation with laboratory and clinical parameters, and genetics[J]. Eur Thyroid J, 2018,7(1):27-33. DOI: 10.1159/000484521.

[18] Das G, Taylor PN, Javaid H, et al. Seasonal variation of vitamin d and serum thyrotropin levels and its relationship in a euthyroid caucasian population[J]. Endocr Pract, 2018,24(1):53-59. DOI: 10.4158/EP-2017-0058.

[19] Chahardoli R, Saboor-Yaraghi AA, Amouzegar A, et al. Can supplementation with vitamin D modify thyroid autoantibodies (Anti-TPO Ab, Anti-Tg Ab) and thyroid profile (T3, T4, TSH) in hashimoto's thyroiditis? A double blind, randomized clinical trial[J]. Horm Metab Res, 2019,51(5):296-301. DOI: 10.1055/a-0856-1044.

[20] Bingol Z, Karaayvaz EB, Telci A, et al. Leptin and adiponectin levels in obstructive sleep apnea phenotypes[J]. Biomark Med, 2019,13(10):865-874. DOI: 10.2217/bmm-2018-0293.

[21] Zhang DM, Pang XL, Huang R, et al. Adiponectin, omentin, ghrelin, and visfatin levels in obese patients with severe obstructive sleep apnea[J]. Biomed Res Int, 2018,2018:3410135. DOI: 10.1155/2018/3410135.

[22] Komai AM, Musovic S, Peris E, et al. White adipocyte adiponectin exocytosis is stimulated via β3-adrenergic signaling and activation of epac1: catecholamine resistance in obesity and Type 2 diabetes[J]. Diabetes, 2016,65(11):3301-3313. DOI: 10.2337/db15-1597.

[23] Delitala AP, Scuteri A, Fiorillo E, et al. Role of adipokines in the association between thyroid hormone and components of the metabolic syndrome[J]. J Clin Med, 2019,8(6):764. DOI: 10.3390/jcm8060764.

[24] de Oliveira M, Rodrigues BM, Olimpio RMC, et al. Adiponectin and serine/threonine kinase akt modulation by triiodothyronine and/or LY294002 in 3T3-L1 adipocytes[J]. Lipids, 2019,54(2-3):133-140. DOI: 10.1002/lipd.12135.

[25] Cruz-Mejía S, Durán López HH, Navarro Meza M, et al. Body mass index is associated with interleukin-1, adiponectin, oxidative stress and ioduria levels in healthy adults[J]. Nutr Hosp, 2018,35(4):841-846. DOI: 10.20960/nh.1614.

[26] Kuetting DLR, Feisst A, Sprinkart AM, et al. Effects of a 24-hr-shift-related short-term sleep deprivation on cardiac function: a cardiac magnetic resonance-based study[J]. J Sleep Res, 2019,28(3):e12665. DOI: 10.1111/jsr.12665.

[27] Tang X, Yang LX, Zhang M, , et al.Cognitive status and its relationship with serum neuropeptide Y in patients with obstructive sleep apnea hypopnea syndrome[J]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2018,32(18):1414-1417. DOI: 10.13201/j.issn.1001-1781.2018. 18.012.

[28] Baltaci AK, Mogulkoc R. Leptin, NPY, melatonin and zinc levels in experimental hypothyroidism and hyperthyroidism: the relation to zinc[J]. Biochem Genet, 2017,55(3):223-233. DOI: 10.1007/s10528-017-9791-z.

[29] Soin D, Kumar PA, Chahal J, et al. Evaluation of obstructive sleep apnea in metabolic syndrome[J]. J Family Med Prim Care, 2019,8(5):1580-1586. DOI: 10.4103/jfmpc.jfmpc_175_19.

[30] Lee UK, Liu SY, Zeidler MR, et al. Severe obstructive sleep apnea with imaged carotid plaque is significantly associated with systemic inflammation[J]. J Oral Maxillofac Surg, 2019,77(8):1636-1642. DOI: 10.1016/j.joms.2019.02.005.

[31] Stolarczyk E. Adipose tissue inflammation in obesity: a metabolic or immune response?[J]. Curr Opin Pharmacol,2017,37:35-40. DOI: 10.1016/j.coph.2017.08.006.

[32] Paschou SA, Palioura E, Kothonas F, et al. The effect of anti-TNF therapy on thyroid function in patients with inflammatory bowel disease[J]. Endocr J, 2018,65(11):1121-1125. DOI: 10.1507/endocrj.EJ18-0243.

[33] Lv LF, Jia HY, Zhang HF, et al. Expression level and clinical significance of IL-2, IL-6 and TGF-β in elderly patients with goiter and hyperthyroidism[J]. Eur Rev Med Pharmacol Sci, 2017,21(20):4680-4686.

Mechanism of obesity influencing thyroid function in patients with obstructive sleep apnea hypopnea syndrome

肥胖对OSAHS患者甲状腺功能影响机制的研究进展

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 1

Recommended Articles

Metrics