Associations Among Obstructive Sleep Apnea, Thyroid Function and Morphology Changes.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-07-29 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S507318

Yushan Xie, Hongli Zhang, Zine Cao, Yanuo Zhou, Chendi Lu, Libo Yin, Simin Zhu, Yonglong Su, Xiaoxin Niu, Lina Ma, Yuqi Yuan, Yitong Zhang, Zitong Wang, Haiqin Liu, Xiaoyong Ren, Yewen Shi

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Abstract

Purpose: This study unveils the complex interplay among obstructive sleep apnea (OSA), thyroid function, and morphological changes.

Methods: Data from 1,102 patients were collected retrospectively from the Department of Otorhinolaryngology-Head and Neck Surgery of the Second Affiliated Hospital of Xi'an Jiaotong University from 2012 to 2023. The patients were divided into severe and non-severe OSA groups according to their polysomnography results. The data were analyzed by sex and age stratification.

Results: Serum free triiodothyronine (FT3), total triiodothyronine (TT3), and reverse triiodothyronine (RT3) were higher in severe OSA group in the total population (p < 0.05). Similar trends were observed in male but not in female. FT3 and TT3 are higher in the severe group in the nonelderly population (age < 60) (p < 0.05), and RT3 is higher in the severe group in the elderly population (age ≥ 60) (p < 0.05). In addition, we first reveal that RT3 is associated with the diameter of the left inferior thyroid artery (L-ITA) (r=0.394, p < 0.05) and lowest transcutaneous oxygen saturation at night (lowest SpO₂) (r=-0.269, p < 0.05). The severe OSA group showed larger thyroid volume and isthmus length, as well as the thicker ITA diameter and lower left thyroid lobe resistance index (RI) (all p < 0.05).

Conclusion: Our study demonstrates a significant association between thyroid function/morphology and OSA, with distinct sex- and age-related differences. Reduced RI in severe OSA suggests its clinical utility in assessing vascular health. Increased thyroid volume and isthmus length in severe OSA may reflect ITA-related changes. These findings support our prior observations of rising thyroid hormone levels with OSA progression and highlight the need for sex- and age-stratified analyses. Integrated evaluation of thyroid function and morphology is essential for understanding OSA-thyroid pathophysiology.

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阻塞性睡眠呼吸暂停、甲状腺功能和形态学改变的关系。

目的：本研究揭示阻塞性睡眠呼吸暂停（OSA）、甲状腺功能和形态学改变之间复杂的相互作用。方法：回顾性收集西安交通大学第二附属医院2012 - 2023年耳鼻咽喉头颈外科1102例患者的资料。根据多导睡眠图结果将患者分为重度和非重度OSA组。数据按性别和年龄分层进行分析。结果：重度OSA组人群血清游离三碘甲状腺原氨酸（FT3）、总三碘甲状腺原氨酸（TT3）、逆转录三碘甲状腺原氨酸（RT3）均高于对照组（p < 0.05）。在男性中观察到类似的趋势，但在女性中没有。非老年人群（年龄< 60岁）重症组FT3、TT3较高（p < 0.05），老年人群（年龄≥60岁）重症组RT3较高（p < 0.05）。此外，我们首次发现RT3与左甲状腺下动脉直径（L-ITA）（r=0.394, p < 0.05）和夜间最低经皮氧饱和度（最低SpO2）（r=-0.269, p < 0.05）相关。重度OSA组甲状腺体积、峡长较大，ITA直径较粗，左侧甲状腺叶阻力指数（RI）较低（p < 0.05）。结论：我们的研究表明，甲状腺功能/形态与OSA之间存在显著相关性，且存在明显的性别和年龄相关差异。严重OSA患者RI降低提示其在评估血管健康方面的临床应用。严重OSA患者甲状腺体积和峡部长度的增加可能反映了ita相关的变化。这些发现支持了我们之前关于甲状腺激素水平随着OSA进展而升高的观察，并强调了对性别和年龄分层分析的必要性。综合评价甲状腺功能和形态是了解osa -甲状腺病理生理的必要条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.