Obstrüktif Uyku Apne Sendromlu orta yaşlı erkeklerde osteoporoz ve osteoporozla ilgili parametreler
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Tarih
2010
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Selçuk Üniversitesi Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Özet
Giriş ve amaç: OUAS'ın erkeklerde erken yaşta osteoporoz gelişimi ile ilişkisini araştırmak için, orta yaşlı OUAS'lı erkek hastalarda normallere göre kemik mineral dansitesi (KMD)'nde değişim olup olmadığı ve KMD ile ilişkili olabilecek GH, IGF-1, serbest testosteron, total testosteron ve SHBG seviyeleri ve bunların ilişkili olduğu klinik parametreler yaş, obezite, ek hastalık, alkolizm, ilaç kullanma ve sigara içme durumlarının etkisi dışlanarak araştırıldı. Materyal ve Metod: Çalışmaya alınan tüm olgulardan tanı için uygulanan PSG sonrası sabah 07 00-08 00 arasında alınan kan örneklerinde GH, IGF-1, total testosteron ve SHBG düzeyleri ELISA yöntemi ile, serbest testosteron düzeyi ise RIA yöntemi ile ölçüldü. Yine çalışmaya alınan tüm olguların KMD değerleri DEXA yöntemi ile ölçüldü. Bulgular: Vakalar OUAS'lı olmayan kontrol grubu (n=22) ile orta ve ağır dereceli OUAS'lı olan hasta grubu (n=24) olmak üzere 2 gruba ayrıldı. Bu iki grup arasında EUÖ, AHI, min SaO2, ort SaO2, ?%90 SaO2 süresi oranı ve boyun çevresi ölçümleri istatistiki olarak farklıydı. Hasta ve kontrol grupları arasında yaş, sigara kullanımı, boyun çevresi, VKİ, UE, NREM3 süresi oranı ve REM süresi oranı arasında istatistiki olarak anlamlı farklılık saptanmadı. OUAS'lı hasta grubunda 5 kişide osteoporoz tespit edildi (%20,8). Kontrol grubunda hiçbir kişide osteoporoz tespit edilmedi (%0). Osteoporoz açısından gruplar arasında istatistiki olarak sınırda bir anlamlılık mevcuttu (p=0,05). T-skoru AP ve T-skoru femur değerleri de OUAS'lı grupta kontrollerden daha düşüktü ancak gruplar arasında istatistiksel bir farklılık yoktu. İki grup arasında GH, IGF-1, serbest testosteron, total testosteron, SHBG seviyeleri açısından da istatistiksel bir farklılık elde edilmedi. OUAS'lı grupta GH ile NREM3 süresi oranı arasında (p=0,039), T-skoru femur ile REM süresi oranı arasında (p=0,032), istatistiksel olarak anlamlı pozitif bir ilişki mevcuttu; T-skoru AP ile serbest testosteron arasında (p=0,094) ve T-skoru femur ile IGF-1 arasında (p=0,067) da pozitif bir ilişki mevcuttu; ancak bu ilişkiler istatistiki olarak anlamlı düzeyde değildi. Yine OUAS'lı grupta SHBG ile ?%90 SaO2 süresi oranı arasında bir ilişki vardı; ancak bu ilişki istatistiksel olarak anlamlı düzeyde değildi (p=0,079). Diğer parametreler arasındaki korelasyon analizlerinde ise anlamlı ilişki saptanmadı. Sonuçlar: Sonuç olarak OUAS'ın erkek hastalarda erken yaşta osteoporoza bir eğilim oluşturduğu, bunun REM uyku süresinin kısalığı, IGF-1 ve serbest testosteron seviyeleri ile ilişkili olabileceği tespit edildi.
Introduction and Purpose: In order to explore the relationship between OSAS and the development of osteoporosis in men at an early age, whether any bone mineral density change compared to normal values occurs in middle-aged male patients with OSAS, and GH, IGF-1, free testosterone, total testosterone and SHBG levels, which may be related to bone mineral density, and clinical parameters that these are related to were investigated excluding the impact of the age, obesity, comorbidity, alcoholism, drug use and smoking status. Material and Method: In the blood samples taken from all cases which were included in study, in the morning 07 00-08 00 after applying PSG for diagnosis, GH, IGF-1, total testosterone and SHBG levels were measured by ELISA method whereas the free testosterone level was measured by RIA method. Again bone mineral densities of all cases which were included in study were measured by DEXA method. Results: The cases were divided into two groups such that a control group without OSAS (n=22) and a patient group with moderate and severe degree of OSAS (n=24). Between these two groups, ESS, AHI, min SaO2, mean SaO2, elapsed time with 90% and more saturation at night and neck circumference values were statistically different. Between the patient group and the control group, no statistically significant difference was detected between the age, smoking status, neck circumference, BMI, sleeping efficiency, the rate of NREM3 sleep duration and the rate of REM sleep duration. Osteoporosis was detected in five people from OSAS patient group (20.8%) whereas it was not detected in anyone from the control group (0%). In terms of osteoporosis, there was marginally statistical difference between the groups (p=0.05). T-score AP and T-score femur values are also lower in OSAS patient group than the control group, but no statistical difference was present between the groups. Again no statistical difference was obtained in terms of GH and IGF-1, free testosterone, total testosterone and SHBG levels between two groups. In OSAS patient group, there were statistically significant positive correlations between GH and NREM3 duration rate (p=0.039), and between T-score femur and REM duration rate (p=0.032). Moreover, positive relationships were present between T-score AP and free testosterone (p=0.094), and between T-score femur and IGF-1 (p=0.067), but these relations were not statistically significant. Again in OSAS patient group, there was a relationship between SHBG and the rate of elapsed time with 90% and more oxygen saturation at night (p=0.079), yet this relation was also not statistically significant. No significant relationship was found in correlation analyses between other parameters. Conclusion: In conclusion, it is found that OSAS causes a tend to develop osteoporosis in male patients at an early age, and this may be related to the shortness of REM sleep duration, and the levels of IGF-1 and free testosterone.
Introduction and Purpose: In order to explore the relationship between OSAS and the development of osteoporosis in men at an early age, whether any bone mineral density change compared to normal values occurs in middle-aged male patients with OSAS, and GH, IGF-1, free testosterone, total testosterone and SHBG levels, which may be related to bone mineral density, and clinical parameters that these are related to were investigated excluding the impact of the age, obesity, comorbidity, alcoholism, drug use and smoking status. Material and Method: In the blood samples taken from all cases which were included in study, in the morning 07 00-08 00 after applying PSG for diagnosis, GH, IGF-1, total testosterone and SHBG levels were measured by ELISA method whereas the free testosterone level was measured by RIA method. Again bone mineral densities of all cases which were included in study were measured by DEXA method. Results: The cases were divided into two groups such that a control group without OSAS (n=22) and a patient group with moderate and severe degree of OSAS (n=24). Between these two groups, ESS, AHI, min SaO2, mean SaO2, elapsed time with 90% and more saturation at night and neck circumference values were statistically different. Between the patient group and the control group, no statistically significant difference was detected between the age, smoking status, neck circumference, BMI, sleeping efficiency, the rate of NREM3 sleep duration and the rate of REM sleep duration. Osteoporosis was detected in five people from OSAS patient group (20.8%) whereas it was not detected in anyone from the control group (0%). In terms of osteoporosis, there was marginally statistical difference between the groups (p=0.05). T-score AP and T-score femur values are also lower in OSAS patient group than the control group, but no statistical difference was present between the groups. Again no statistical difference was obtained in terms of GH and IGF-1, free testosterone, total testosterone and SHBG levels between two groups. In OSAS patient group, there were statistically significant positive correlations between GH and NREM3 duration rate (p=0.039), and between T-score femur and REM duration rate (p=0.032). Moreover, positive relationships were present between T-score AP and free testosterone (p=0.094), and between T-score femur and IGF-1 (p=0.067), but these relations were not statistically significant. Again in OSAS patient group, there was a relationship between SHBG and the rate of elapsed time with 90% and more oxygen saturation at night (p=0.079), yet this relation was also not statistically significant. No significant relationship was found in correlation analyses between other parameters. Conclusion: In conclusion, it is found that OSAS causes a tend to develop osteoporosis in male patients at an early age, and this may be related to the shortness of REM sleep duration, and the levels of IGF-1 and free testosterone.
Açıklama
Anahtar Kelimeler
Osteoporoz, Osteoporosis, Testosteron, Testosterone
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Sayı
Künye
Aslan, S. H. (2010). Obstrüktif Uyku Apne Sendromlu orta yaşlı erkeklerde osteoporoz ve osteoporozla ilgili parametreler. Selçuk Üniversitesi, Yayımlanmış tıpta uzmanlık tezi, Konya.
