The Effect Of Hypothalamic-pituitary-thyroid Axis Hormone Levels And Depression In Obstructive Sleep Apnea-hypopnea Syndrome

Objective:To explore the change of hypothalamic-pituitary-thyroid axis hormones and it’s role in depression in obstructive sleep apnea-hypopnea syndrome.Methods:73 male OSAHS patients（age 39.22±10.68years）and 13 male controls（age35.53±7.51years）were enrolled from August 2013 to May 2017 in the 1st Hospital of China Medical University.Overnight polysomnography and depression were assessed.According to the diagnostic criteria formulated by the Sleep Respiratory Disease Group of the Society of Respiratory Diseases of the Chinese Medical Association,the patients were divided into simple snoring control group（AHI<5 times/hour,SpO₂>90%,n=13）,OSAHS group（n=73）.According to AHI,OSAHS group was further divided into mild OSAHS group（5<AHI<15 times/hour,n=17）,moderate OSAHS group（15<AHI<30 times/hour,n=18）,severe OSAHS group（AHI<30 times/hour,n=18）.According to SpO₂,OSAHS was divided into mild hypoxia group（85<SpO₂<90%,n=17）,moderate hypoxia group（80<SpO₂<85%,n=15）,severe hypoxia group（SpO₂<80%,n=38）.The serum TRH,TSH,FT₄ and FT₃ levels were measured on the next morning.The relationship between depression and hypothalamic-pituitary-thyroid axis were analyzed.Results:Compared with the control group,severe hypoxia group had higher serum FT₃level（4.46±0.63 pg/ml vs.5.35±0.70pg/ml,p<0.05）and depression score（30.29±6.66 vs.40.03±9.87,p<0.05）.Further analysis revealed that serum FT₃ level（5.00±0.49pg/ml vs.5.50±0.72pg/ml,p<0.05）and FT₄ level（16.23±1.89pg/ml vs.18.18±2.34pg/ml,p<0.05）were lower in the patients with depression than those without.Conclusion:OSAHS patients with severe hypoxia are prone to abnormal thyroid hormone levels,the decrease of serum FT₃ and FT₄ levels in OSAHS patients with severe hypoxia was closely related to the occurrence of depression.