The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes
Aims: Type 2 diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) may adversely affect bone. Gender is a well-established factor influencing bone health. We investigated the impact of OSA on bone mineral density (BMD) and trabecular bone score (TBS) in T2DM. Methods: Eighty-one T2DM patients [...
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doaj-c08802b51cc544ab95a8d9579ba1d4d02020-11-25T02:22:47ZengElsevierJournal of Clinical & Translational Endocrinology2214-62372019-06-0116The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetesHataikarn Nimitphong0Nantaporn Siwasaranond1Chanika Sritara2Sunee Saetung3La-or Chailurkit4Naricha Chirakalwasan5Boonsong Ongphiphadhanakul6Sirimon Reutrakul7Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Corresponding author.Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Division of Endocrinology, Diabetes and Metabolism, University of Illinois at Chicago, Chicago, IL, USAAims: Type 2 diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) may adversely affect bone. Gender is a well-established factor influencing bone health. We investigated the impact of OSA on bone mineral density (BMD) and trabecular bone score (TBS) in T2DM. Methods: Eighty-one T2DM patients [33 men and 48 women] participated. OSA was diagnosed using an overnight monitor, with its severity assessed by an apnea hypopnia index (pAHI). The measurements of hypoxia, including the percentage of total sleep time in which oxygen saturation remains below 90% (pT90), the oxygen desaturation index (pODI) and minimum O2 (min O2), were reported. Lumbar spine (L1-4) and femoral neck (FN) BMD were measured using dual-energy X-ray absorptiometry (DXA). TBS was computed from DXA images. Results: Sixty-five patients (80.2%) had OSA. pAHI, pT90, pODI and min O2 were not correlated to L1-4 BMD, FN BMD or TBS in all participants by multiple regression analyses adjusting for age, gender and BMI. However, an interaction between gender and pAHI, and gender and pODI were significantly associated with TBS (b = 0.003, p = 0.034 and b = 0.004, p = 0.046, respectively). We therefore reassessed an association between pAHI or pODI and TBS separately between men and women. After adjusting for age and BMI, more severe OSA (higher pAHI) and higher pODI significantly associated with lower TBS (b = −0.002, p = 0.034 and b = −0.003, p = 0.021, respectively) in men. On the other hand, higher pAHI non-significantly associated with better trabecular microarchitecture as indicated by higher TBS (b = 0.002, p = 0.059) in women. When considered only postmenopausal (n = 33), higher pAHI and higher pODI were significantly associated with higher TBS (b = 0.004, p = 0.003 and b = 0.004, p = 0.008, respectively). Conclusions: In T2DM patients, there is a complex interrelationship among OSA severity, gender and TBS. More severe OSA predicted lower TBS in men, but predicted higher TBS in postmenopausal women. Keywords: Apnea–hypopnea index (AHI), BMD/TBS, Menopausal status, Obstructive sleep apnea, Gender, Type 2 diabeteshttp://www.sciencedirect.com/science/article/pii/S2214623719300316 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hataikarn Nimitphong Nantaporn Siwasaranond Chanika Sritara Sunee Saetung La-or Chailurkit Naricha Chirakalwasan Boonsong Ongphiphadhanakul Sirimon Reutrakul |
spellingShingle |
Hataikarn Nimitphong Nantaporn Siwasaranond Chanika Sritara Sunee Saetung La-or Chailurkit Naricha Chirakalwasan Boonsong Ongphiphadhanakul Sirimon Reutrakul The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes Journal of Clinical & Translational Endocrinology |
author_facet |
Hataikarn Nimitphong Nantaporn Siwasaranond Chanika Sritara Sunee Saetung La-or Chailurkit Naricha Chirakalwasan Boonsong Ongphiphadhanakul Sirimon Reutrakul |
author_sort |
Hataikarn Nimitphong |
title |
The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes |
title_short |
The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes |
title_full |
The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes |
title_fullStr |
The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes |
title_full_unstemmed |
The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes |
title_sort |
differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes |
publisher |
Elsevier |
series |
Journal of Clinical & Translational Endocrinology |
issn |
2214-6237 |
publishDate |
2019-06-01 |
description |
Aims: Type 2 diabetes mellitus (T2DM) and obstructive sleep apnea (OSA) may adversely affect bone. Gender is a well-established factor influencing bone health. We investigated the impact of OSA on bone mineral density (BMD) and trabecular bone score (TBS) in T2DM. Methods: Eighty-one T2DM patients [33 men and 48 women] participated. OSA was diagnosed using an overnight monitor, with its severity assessed by an apnea hypopnia index (pAHI). The measurements of hypoxia, including the percentage of total sleep time in which oxygen saturation remains below 90% (pT90), the oxygen desaturation index (pODI) and minimum O2 (min O2), were reported. Lumbar spine (L1-4) and femoral neck (FN) BMD were measured using dual-energy X-ray absorptiometry (DXA). TBS was computed from DXA images. Results: Sixty-five patients (80.2%) had OSA. pAHI, pT90, pODI and min O2 were not correlated to L1-4 BMD, FN BMD or TBS in all participants by multiple regression analyses adjusting for age, gender and BMI. However, an interaction between gender and pAHI, and gender and pODI were significantly associated with TBS (b = 0.003, p = 0.034 and b = 0.004, p = 0.046, respectively). We therefore reassessed an association between pAHI or pODI and TBS separately between men and women. After adjusting for age and BMI, more severe OSA (higher pAHI) and higher pODI significantly associated with lower TBS (b = −0.002, p = 0.034 and b = −0.003, p = 0.021, respectively) in men. On the other hand, higher pAHI non-significantly associated with better trabecular microarchitecture as indicated by higher TBS (b = 0.002, p = 0.059) in women. When considered only postmenopausal (n = 33), higher pAHI and higher pODI were significantly associated with higher TBS (b = 0.004, p = 0.003 and b = 0.004, p = 0.008, respectively). Conclusions: In T2DM patients, there is a complex interrelationship among OSA severity, gender and TBS. More severe OSA predicted lower TBS in men, but predicted higher TBS in postmenopausal women. Keywords: Apnea–hypopnea index (AHI), BMD/TBS, Menopausal status, Obstructive sleep apnea, Gender, Type 2 diabetes |
url |
http://www.sciencedirect.com/science/article/pii/S2214623719300316 |
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