Lack of associations between thyroid function and obstructive sleep apnea severity in adults with prediabetes and diabetes mellitus
Hypothyroidism is associated with a high frequency of obstructive sleep apnea (OSA). However, the prevalence of OSA in hypothyroid patients is not different from the general population in many reports. The importance of thyroid function screening in sleep-disordered breathing is still controversial. This study aimed to explore the association between thyroid dysfunction and OSA in the adults with prediabetes or diabetes mellitus type 2, who have very high prevalence of OSA.
OSA was assessed using an in-home monitoring device, WatchPAT200. OSA severity was measured using apnea-hypopnea index (AHI), oxygen desaturation index (ODI), minimum oxygen saturation (minO2), and time spent under oxygen saturation < 90% (T90). Patients with pre-existing thyroid dysfunction were excluded.
Participants included 70 men and 118 women with mean age 52.8 ± 10.9 years and body mass index 28.2 ± 4.9 kg/m2. One hundred forty participants (75%) had OSA, with a median AHI of 10.1 (interquartile range 4.8, 18.3). The percentage of positive thyroid autoantibody (thyroperoxidase and thyroglobulin antibody) was similar among the subjects with and without OSA. There was no correlation between the levels of thyroid function (TSH, FT3, FT4, TSH/FT3, and TSH/FT4 ratio) and the severity indices of OSA (AHI, ODI, minO2, and T90).
These data do not support universal screening for thyroid dysfunction in OSA patients with diabetes or prediabetes.
KeywordsHypothyroidism Polysomnography Sleep apnea syndromes Thyrotropin Thyroxine Triiodothyronine
Study concept and design, manuscript drafting: CS, SP, OS, SR. Data collection: HN, NC, SS, TA, NS, AM, LC, SR. Data interpretation, critical revision of the manuscript, and final approval: all authors.
This study was supported by the Endocrine Society of Thailand and Mahidol University. Assay for thyroid function and autoantibodies were provided by Roche Diagnostics (Thailand).
Compliance with ethical standards
HN received honoraria from Sanofi, Novo Nordisk, MSD, Takeda, Novartis, Amgen, and AstraZeneca. SR received a grant from MSD and honoraria from Sanofi, Medtronic, Novo Nordisk, and research equipment support from ResMed, Thailand. All other authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Written informed consent was obtained from all individual participants included in the study.
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