Evaluation of thyroid functions and obesity in obstructive sleep apnea syndrome

The mean patient age was 49.3±11.5 years, and the majority were obese (67.9%) or overweight (26.6%). The mean age of the patients in Group 2 (moderate/severe obstructive sleep apnea syndrome) was higher than that of Group 1 (simple snoring/mild obstructive sleep apnea syndrome). The rate of severe obstructive sleep apnea syndrome among obese patients (35.2%) was significantly higher than that of normal-weight (11.6%) and overweight (18.3%) patients (p=0.001). The oxygen desaturation index/apnea-hypopnea index and levels of leukocytes and C-reactive protein were significantly higher, while mean/minimum saturation values and hemoglobin, hematocrit, and free triiodothyronine levels were significantly lower among obese patients compared with overweight and normal-weight patients (p=0.001). Leukocytes, C-reactive protein, and apnea-hypopnea index/oxygen desaturation index values were higher, and mean/minimum saturation values were lower in Group 2 than in Group 1.

CONCLUSION:

There were relationships between obstructive sleep apnea syndrome severity and body mass index. Obesity could be a critical predisposing factor for sleep disturbances. The prevention and control of obesity is important while being treated for obstructive sleep apnea syndrome.

Keywords
Body fat distribution; Body mass index; Obesity; Sleep apnea, obstructive

Parameters	All patients	Group 1	Group 2	p
Age (years)	49.3±11.5	46.4±11.4	51.8±11	0.001*
Hemoglobin (g/dL)	14.7 (8.2-19.7)	14.3 (8.2-18.5)	14.3 (10.6-19.7)	0.810
Hematocrit (%)	43.4±5.2	42.4±5.7	43±5.3	0.260
Leukocyte (K/UL)	7.9 (0.5-20.5)	7.8 (3.9-16.6)	8.5 (0.5-20.5)	0.002^α αleukocyte count was significantly higher in group 2 than group 1;
CRP (mg/L)	0.5 (0.0-23.1)	0.5 (0.0-11.8)	0.6 (0.0-23.1)	0.001^β βCRP was significantly higher in group 2 than group 1;
TSH (mU/L)	1.7 (0.0-11.3)	1.7 (0.1-10.8)	1.7 (0.0-10.3)	0.772
FT4 (ng/dL)	1.2 (0.1-5.5)	1.2 (0.8-2.7)	1.2 (0.1-3.7)	0.143
FT3 (ng/dL)	3.1±0.5	3.1±0.5	3.0±0.5	0.159
Body mass index	32.6 (20.1-57.8)	34.7 (30.0-51.1)	35.8 (30.0-57.8)	0.002^γ γBMI was significantly higher in group 2 than group 1;
Body fat ratio	40.0±11.8	43.5±10.3	46.2±10.1	0.003^¶ ¶BFR was significantly higher in group 2 than group 1;
AHI	16.5 (0.0-109.8)	6.4 (0.0-15)	32.0 (15.0-109.8)	0.001^§ §AHI was significantly higher in group 2 than group 1;
Mean saturation	91.6 (61.4-97.6)	92.5 (66.3-97.6)	90.3 (61.4-96.5)	0.001^μ μmean saturation was significantly lower in group 2 than group 1;
Minimum saturation	80.0 (50.0-95.0)	85.0 (50.0-95.0)	75.0 (50.0-89.0)	0.001^ε εminimum saturation was significantly lower in group 2 than group 1;
ODI	18.9 (0.1-113.9)	7.8 (0.1-58.6)	36.3 (5.7-113.9)	0.001^¥ ¥ODI value was significantly higher in group 2 than group 1.

	Normal weight (n=43)	Overweight (n=208)	Obese (n=531)	p
Hemoglobin (g/dL)	15.1 (11.3-17.4)	15.3 (10.5-18.5)	14.3 (8.2-19.7)	*0.001^ Obese patients had significantly lower hemoglobin than the overweight and normal-weight patients;*
Hematocrit (%)	44.7 (34.1-53.8)	45.0 (33.7-55.0)	42.8 (0.0-60.6)	0.001^α αobese patients had significantly lower hematocrit than the overweight and normal-weight patients;
Leukocyte (K/UL)	7.7 (1.0-12.4)	7.5 (0.0-19.0)	8.2 (0.5-20.5)	0.001^α αobese patients had significantly lower hematocrit than the overweight and normal-weight patients;
CRP (mg/L)	0.2 (0.0-6.7)	0.3 (0.0-14.7)	0.5 (0.0-23.1)	0.001^γ γCRP levels were significantly higher in obese patients than overweight and normal-weight patients;
TSH (mU/L)	1.8 (0.6-4.8)	1.8 (0.0-11.3)	1.7 (0.0-10.8)	0.338
FT4 (ng/dL)	1.2 (1.0-1.5)	1.2 (0.3-5.5)	1.2 (0.1-3.6)	0.065
FT3 (ng/dL)	3.1±0.4	3.3±0.6	3.1±0.5	0.001^¶ ¶mean FT3 was lower in obese patients than overweight and normal-weight patients;
AHI	3.0 (0.0-45.4)	14.5 (0.3-87.5)	18.4(0.0-109.8)	0.001^§ §AHI values were significantly higher in obese patients;
Mean saturation	94.2 (79.7-96.8)	92.5 (63.9-96.4)	90.6 (61.4-97.6)	0.001^μ μmean saturation values were significantly lower in obese patients;
Minimum saturation	89.0 (51.0-94.0)	84.0 (50.0-92.0)	77.0 (0.0-95.0)	0.001^ε εminimum saturation values were significantly lower in obese patients;
ODI	3.8 (0.1-60.4)	14.3 (0.3-97.8)	22.6 (0.2-114)	0.001^¥ ¥ODI values were significantly higher in obese patients;
Simple snoring, n (%)	25 (58.1)	43 (20.7)	64 (12.1)	0.001^† †severe OSAS was higher in obese patients than overweight and normal-weight patients;
Mild OSAS, n (%)	10 (23.3)	68 (32.7)	151 (28.4)
Moderate OSAS n (%)	3 (7.0)	59 (28.4)	129 (24.3)
Severe OSAS, n (%)	5 (11.6)	38 (18.3)	187 (35.2)
Body fat ratio	22.3 (14.4-38)	29 (20.0-46.0)	44.9 (25.1-74.8)	0.001^⁕ ⁕BFR values were significantly higher in obese patients than overweight and normal-weight patients.

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] *Corresponding author: fduksal@gmail.com