A Study On Obstructive Sleep Apnea-hypopnea Syndrome With Thyroxine

ObjectiveThe purpose of this study was to investigate the change of plasma thyroxine(FT3,FT4,sTSH) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and probe into its action in the process of devepment of OSAHS.And then seek some effective ways to treat the patients with OSAHS.MethodsFollowing 7 hours'polysomnographic examination,116 habitual snorers were selected and divided into 4 groups by two diffent ways:1.acording to the diffences of AHI: 10 simple snorers,28 low-grade OSAHS,34 moderate OSAHS and 34 severe OSAHS . 2. acording to the diffences of minSPO2:21 snores without anoxemia,43 snores with low-grade anoxemia,30 snores with moderate anoxemia,22 snores with severe anoxemia. Step 1, plasma concentrations of FT3,FT4 and sTSH were measured . Compare the difference of FT3,FT4,sTSH among diffent groups and then seek the correlations between the thyroxine and some factors including minSPO2,ODI4,TS90%,ESS,blood-fat,fasting blood-glucose and so on.Step2,90 OSAHS patients accepted nasal continuous positive airway pressure (nCPAP) therapy , 30 OSAHS patients were selected ,including 7 snores with low-grade anoxemia,12 snores with moderate anoxemia,11 snores with severe anoxemia. After 3 months nCPAP therapy, FT3,FT4 and sTSH were measured again.Results1.In diffent AHI groups, the concentrations of FT4 were diffent and the differences were significant, the concentrations of FT4 in severe OSAHS group were lower than the other groups by SNK-q method. The concentrations of FT3 and TSH were no diffent,and after tested by S-N-K method, there was no significant difference among the groups too.2.In indiffent anoxemia groups, the concentrations of FT4 were significant diffent,and the concentrations of FT4 were also significant diffent among the 4 groups by S-N-K method . The concentrations of FT3 and TSH were no diffent,after tested by S-N-K method, there was no significant difference between the groups too.3.FT4 exhibited positive correlations with minSPO2 ( r= 0.899,P<0.01),and exhibited negative correlations with ODI4(r= -0.861,P<0.01),TS90%(r= -0.821,P<0.01),ESS(r= -0.759,P<0.01). FT4 exhibited some correlations with TCHO(r= -0.183,P<0.05),TG(r= -0.372,P<0.05)VLDL(r= -0.476,P<0.01)and fasting blood-glucose (r= -0.145,P>0.05).FT3 and TSH exhibited no signifcant correlations with upwords indexes.4.Multiple regression analysis showed that minSPO2, ESS ,ODI4 and AHTI were independently predictors of FT4,the t values were 6.004(P<0.01),-5.022 (P<0.01),-3.386(P<0.05),-1.988 (P<0.05) spectively. The multiple regression equationassociated was FT4=-2.286+0.275X1-0.084X2-0.16X3-0.023X4.5.After 3 months'nCPAP therapy, FT4 concentrations in 30 OSAHS increased significantly, but FT3 and sTSH had no significant change.Conclusion1. Patients with severe OSAHS had lower FT4 levels than other groups.We can speculate OSAHS can cause the change of thyroxine.2.The FT4 levels decreased with the anoxemia .We can speculate anoxemia was a important cause for the change of thyroxine level.3. FT4 exhibited important correlations with minSPO2, ODI4,TS90%,ESS, TCHO,TG and VLDL.We can speculate there were significant correlations between episodic hypoxia and thyroxine level. The episodic hypoxia can redue excessive daytime sleepiness and the change of TCHO,TG and VLDL.4. The nCPAP therapy can increse FT4 concentrations , so nCPAP can prevention and relieve the damage in OSAHS.