Relationship Between Serum Adiponectin And Bone Mineral Density In Male Patients With Obstructive Sleep Apnea And Hyponea Syndrome

PurposeRecently,there has been a literature on the potential relationship between obstructive sleep apnea and hyponea syndrome(OSAHS)and bone metabolism.However,the effect of OSAHS on bone metabolism is still controversial,and the underlying mechanisms are far from clear.There was no previous report on the association between adiponectin and bone metabolism in patients with OSAHS.The purpose of our study was to investigate whether bone mineral density and bone turnover markers were different between OSAHS patients and those without OSAHS.We also wanted to assess the association between adiponectin,bone turnover markers and BMD in OSAHS patients.MethodsPatients were continuous collection from the First Affiliated Hospital of Fujian Medical University due to daytime sleepiness,nocturnal sleep during the snoring,apnea and other symptoms during August 2015 to August 2016.All patients were completed with the Epworth Sleepiness Scale(ESS)and detailed questionnaires on sleep symptoms,place of residence,work,history of smoking and history of drinking,history of disease and history of drug use.(25(OH)-VD3),β-I collagen cross-linked C-terminal peptide(β-I),and the levels of serum adiponectin,calcium,(TEX),N-terminal osteocalcin,type I collagen(PINP),blood lactate and arterial blood pH were measured by double energy X-ray absorptiometry(DEXA).All the data were analyzed by SPSS19.0 statistical software.The effects of confounding factors on bone mineral density were excluded by multiple stepwise regression analysis,and independent factors that could affect bone density were screened out.ResultsFinally,84 male patients entered the study,including 15 in the control group,34 patients with moderate OSAHS,and 35 patients with severe OSAHS.All patients without long history of medication,drinking history.There were no differences in age,neck circumference,waist circumference,BMI,blood pressure and smoking history among the three groups.There were no differences in the pH values of calcium,phosphorus,25(OH)-VD3,β-CTx,osteocalcin,PINP,blood lactate and arterial blood between the three groups.Serum adiponectin decreases with increasing OSAHS.Patients with OSAHS had higher BMD and T values in the hip joint(p = 0.027 and p = 0.028)compared with those without OSAHS.For OSAHS patients,serum adiponectin levels were significantly associated with total hip BMD,hip t-score,AHI,and ODI,even after adjustment for age and BMI(r =-0.318,p = 0.002;r =-0.346,p = 0.004;r =-0.388,p = 0.001;r =-0.259,p = 0.032;conversely,all BMD in the hip was positively correlated with AHI and ODI,BMI still had a significant positive correlation(r = 0.292,p = 0.015;r = 0.321,p = 0.007).After multiple stepwise regression analysis,serum adiponectin and ODI were independently associated with all BMD in the hip joint.ConclusionsThe presence of OSAHS does not induce a decrease in total BMD in the hip,intermittent hypoxia associated with lower levels of serum adiponectin or may explain the association between OSAHS and bone metabolism.In order to better understand this complex relationship,randomized controlled studies,including larger population samples,to assess the multifaceted influencing factors and in vitro studies to explore the specific mechanisms of association between OSAHS and bone metabolism.