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Obstructive sleep apnea and serum total testosterone: a system review and meta-analysis

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Abstract

Purpose

Testosterone deficiency (TD) negatively affects male sexuality, reproduction, general health, and quality of life. In recent years, decreased serum testosterone levels have been reported to be caused by obstructive sleep apnea (OSA). However, these results are controversial and lack the support of a large number of high-quality studies. Hence, we performed a meta-analysis to assess the association between OSA and serum testosterone levels.

Methods

To identify eligible studies, we conducted a systematic retrieval in the electronic databases (PubMed, Web of Science, the Cochrane Library, EMBASE) from their inception to September 2021. We chose studies with definitive diagnoses of OSA, including effects of OSA on testosterone level. Random effect model was used for analysis.

Results

This meta-analysis included 24 case–control studies with 1389 patients (1268 male patients) and 845 controls (745 male control). The serum testosterone levels in the male OSA group were significantly lower than that of control group [SMD = − 0.97, 95% CI (− 1.47, − 0.47)], while there was no difference in female patients with OSA and control [SMD = 0.06, 95% CI (− 0.22, 0.33)]. Subgroup analysis showed that race, age, body mass index (BMI), and detection method were the reason for high heterogeneity (I2 = 94.9%).

Conclusions

The results indicated that OSA is significantly correlated with the decrease in serum testosterone levels in men. Male patients with OSA should be alerted to secondary diseases caused by low testosterone levels.

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Data availability

The authors declare that all data supporting the findings of this study are available within the article (and its supplementary information files). The primary data used to support the findings of this study are available from the corresponding author upon request.

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Funding

This study was funded by National Natural Science Foundation of China (No. 81970976 to B. Liu), Chinese Postdoctoral Science Foundation (No. 2021M691380 to H. Wang), Foundation of School/Hospital of Stomatology, Lanzhou University (No. lzujbky-2020-y01 to J. Lu and lzukqky-2021-y06 to L. Xu), and Lanzhou science and technology development guiding plan project (No. 2019-zd-109).

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Author notes

  1. Huihui Wang, Jiyuan Lu, and Lingdan Xu contribute equally to this work

Authors and Affiliations

  1. Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing, School of Stomatology, Lanzhou University, Lanzhou, China

    Huihui Wang, Jiyuan Lu, Lingdan Xu, Yanduo Yang, Yucheng Meng, Yi Li & Bin Liu

  2. College of Civil Engineering and Mechanics, Lanzhou University, Lanzhou, China

    Huihui Wang

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  1. Huihui Wang
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Correspondence to Bin Liu.

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Wang, H., Lu, J., Xu, L. et al. Obstructive sleep apnea and serum total testosterone: a system review and meta-analysis. Sleep Breath 27, 789–797 (2023). https://doi.org/10.1007/s11325-022-02655-6

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  • DOI: https://doi.org/10.1007/s11325-022-02655-6

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