Abstract
Background: Obstructive sleep apnea syndrome (OSAS) is a widespread disorder characterized by recurrent, partial or complete episodes of apnea due to upper airway tract obstruction during sleeping period. Deficiency of vitamin D has roles in development of many diseases. Association between presence and severity of OSAS and vitamin D has recently gained research interest. Aim: The aim of our study was to investigate the association between serum 25-hydroxy [25 (OH)] vitamin D levels and severity of disease in patients with OSAS. Material and Methods: One hundred and fifty OSAS patients (50 patients with mild, 50 with moderate, 50 with severe OSAS) who were diagnosed by polysomnography (PSG) and 32 non-OSAS controls who were referred to the Health Ministry Ankara Numune Training and Research Hospital, Endocrinology and Metabolism Department, from January 2010 to May 2011 were included in the study. Serum 25(OH)D, PTH, calcium and phosphorus levels were evaluated in all the patients who were recruited to the study. Results: There was no statistically significant difference in serum 25(OH)D levels between OSAS and controls (p>0.05). However, in subgroup analysis of OSAS, we found that the patients with severe OSAS had significantly lower levels of 25(OH)D as compared with other groups (p=0.003). Also, the number of patients with serum 25(OH)D deficiency (<10 µg/dl) were higher in OSAS group than in controls (p<0.05). Conclusions: We found that when the severity of OSAS increases, 25(OH)D deficiency becomes more pronounced.
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References
Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008, 5: 136–43.
Lavie P. Incidence of sleep apnea in a presumably healthy working population: a significant relationship with excessive daytime sleepiness. Sleep 1983, 6: 312–8.
Young T, Palta M, Dempsey J, et al. The occurrence of sleep disordered breathing among middle aged adults. N Engl J Med 1993, 328: 1230–5.
Köktürk O. Obstrüktif uyku apne sendromu klinik özellikleri. Tüberküloz ve Toraks Dergisi 1999, 47: 117–26. (in Turkish)
Hollick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancer and cardiovascular disease. Am J Clin Nutr 2004, 80(Suppl. 6): S1678–88.
Ward LM. Vitamin D deficiency in the 21st century: a persistent problem among Canadian infants and mothers. CMAJ 2005, 172: 769–70.
Holick MF. The Vitamin D epidemic and its health consequences. J Nutr 2005, 135: 2739–48.
Heaney RP. Long-latency deficiency disease: insights from calcium and vitamin D. Am J Clin Nutr 2003, 78: 912–9.
Holick MF. Vitamin D: important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. South Med J 2005, 98: 1024–7.
Iber C, Ancoli-Israel S, Chesson AL, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. 1st ed. Westchester, IL: American Academy of Sleep Medicine, 2007.
Jennum P, Riha RL. Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. Eur Respir J 2009, 33: 907–14.
Gami AS, Caples SM, Somers VK. Obesity and obstructive sleep apnea. Endocrinol Metab Clin North Am 2003, 32: 869–94.
Bozkurt NC, Cakal E, Sahin M, Ozkaya EC, Firat H, Delibasi T. The relation of serum 25-hydroxyvitamin-D levels with severity of obstructive sleep apnea and glucose metabolism abnormalities. Endocrine 2012, 41: 518–25.
McCarty DE. Resolution of hypersomnia following indentification and treatment of vitamin D deficiency. J Clin Sleep Med 2010, 15: 605–8.
Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc 2003, 78: 1463–70.
Warner AE, Arnspiger SA. Diffuse musculoskeletal pain is not associated with low vitamin D levels or improved by treatment with vitamin D. J Clin Rheumatol 2008, 14: 12–6.
Carlander B, Puech-Cathala AM, Jaussent I, et al. Low vitamin D in narcolepsy with cataplexy. Plos One 2011, 6: e20433.
Vgontzas AN, Papanicolaou DA, Bixler EO, et al. Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia. J Clin Endocrinol Metab 2000, 85: 1151–8.
Peterson CA, Hefferman ME. Serum tumor necrosis factor-alpha concentrations are negatively correlated with serum 25(OH)D concentrations in healthy women. J Inflamm (Lond) 2008, 5: 10–5.
Vgontzas A, Zoumakis E, Lin HM, Bixler EO, Trakada G, Chrousos GP. Marked decrease in sleepiness in patients with sleep apnea by etanercept, a tumor necrosis factor-alpha antagonist. J Clin Endocrinol Metab 2004, 89: 4409–13.
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Mete, T., Yalcin, Y., Berker, D. et al. Obstructive sleep apnea syndrome and its association with vitamin D deficiency. J Endocrinol Invest 36, 681–685 (2013). https://doi.org/10.3275/8923
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DOI: https://doi.org/10.3275/8923
Key-words
- Apnea-hypopnea index
- 25-hydroxyvitamin D
- obesity
- obstructive sleep apnea syndrome
- polysomnography