{"title":"BMI在男性T2DM患者OSAHS与骨代谢关系中的中介作用","authors":"Ling Ding, Xiaohong Jiang","doi":"10.1007/s11325-025-03302-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the potential association between obstructive sleep apnea hypopnea syndrome (OSAHS) and bone metabolism in male patients with type 2 diabetes mellitus (T2DM), and to further analyze the mediating role of body mass index (BMI) in this relationship. By elucidating the interaction mechanisms between OSAHS and bone metabolism, this study seeks to provide a scientific basis for early screening and intervention of bone metabolism abnormalities in male T2DM patients, thereby improving their clinical outcomes.</p><p><strong>Methods: </strong>This study analyzed 418 male T2DM inpatients from the Department of Endocrine and Metabolic Diseases at the First People's Hospital of Changzhou between May 2020 and May 2024. Patients were categorized into the pure T2DM group and the T2DM with OSAHS group based on their apnea-hypopnea index (AHI). Linear correlation and multiple linear regression analyses were employed to evaluate the relationships among OSAHS, BMI, and bone metabolism indicators. Finally, mediation analysis was conducted to assess the mediating effect of BMI.</p><p><strong>Results: </strong>Among OSAHS indicators, nocturnal lowest oxygen saturation (LSaO2) correlated with total N-terminal propeptide of type I collagen (TP1NP). A 1-SD increase in LSaO2 was associated with a 2.532 ng/ml increase in TP1NP (95% CI: 0.232 ~ 4.832, P < 0.05). While BMI was positively correlated with bone mineral density (BMD), no correlation was found between BMI and bone turnover markers (BTMs). The oxygen desaturation index (ODI) and proportion of cumulative sleep time with oxygen saturation below 90% in total sleep time (T90) was initially correlated with BMD at the different sites, but the association was nullified after adjusting for BMI. Mediation analysis showed that BMI fully mediated the relationship between ODI T90 and BMD, with no influence on the association between LSaO2 and BTMs.</p><p><strong>Conclusion: </strong>OSAHS-induced hypoxia may inhibit osteoblastic activity, which warrants further investigation. Additionally, while BMI fully mediates the relationship between ODI and BMD, further studies are needed to exclude the potential influence of BMI on BMD measurements.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":"29 2","pages":"157"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The mediating role of BMI in the relationship between OSAHS and bone metabolism in male patients with T2DM.\",\"authors\":\"Ling Ding, Xiaohong Jiang\",\"doi\":\"10.1007/s11325-025-03302-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to investigate the potential association between obstructive sleep apnea hypopnea syndrome (OSAHS) and bone metabolism in male patients with type 2 diabetes mellitus (T2DM), and to further analyze the mediating role of body mass index (BMI) in this relationship. By elucidating the interaction mechanisms between OSAHS and bone metabolism, this study seeks to provide a scientific basis for early screening and intervention of bone metabolism abnormalities in male T2DM patients, thereby improving their clinical outcomes.</p><p><strong>Methods: </strong>This study analyzed 418 male T2DM inpatients from the Department of Endocrine and Metabolic Diseases at the First People's Hospital of Changzhou between May 2020 and May 2024. Patients were categorized into the pure T2DM group and the T2DM with OSAHS group based on their apnea-hypopnea index (AHI). Linear correlation and multiple linear regression analyses were employed to evaluate the relationships among OSAHS, BMI, and bone metabolism indicators. Finally, mediation analysis was conducted to assess the mediating effect of BMI.</p><p><strong>Results: </strong>Among OSAHS indicators, nocturnal lowest oxygen saturation (LSaO2) correlated with total N-terminal propeptide of type I collagen (TP1NP). A 1-SD increase in LSaO2 was associated with a 2.532 ng/ml increase in TP1NP (95% CI: 0.232 ~ 4.832, P < 0.05). While BMI was positively correlated with bone mineral density (BMD), no correlation was found between BMI and bone turnover markers (BTMs). The oxygen desaturation index (ODI) and proportion of cumulative sleep time with oxygen saturation below 90% in total sleep time (T90) was initially correlated with BMD at the different sites, but the association was nullified after adjusting for BMI. Mediation analysis showed that BMI fully mediated the relationship between ODI T90 and BMD, with no influence on the association between LSaO2 and BTMs.</p><p><strong>Conclusion: </strong>OSAHS-induced hypoxia may inhibit osteoblastic activity, which warrants further investigation. Additionally, while BMI fully mediates the relationship between ODI and BMD, further studies are needed to exclude the potential influence of BMI on BMD measurements.</p>\",\"PeriodicalId\":21862,\"journal\":{\"name\":\"Sleep and Breathing\",\"volume\":\"29 2\",\"pages\":\"157\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-04-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep and Breathing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11325-025-03302-6\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep and Breathing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11325-025-03302-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
The mediating role of BMI in the relationship between OSAHS and bone metabolism in male patients with T2DM.
Objective: This study aims to investigate the potential association between obstructive sleep apnea hypopnea syndrome (OSAHS) and bone metabolism in male patients with type 2 diabetes mellitus (T2DM), and to further analyze the mediating role of body mass index (BMI) in this relationship. By elucidating the interaction mechanisms between OSAHS and bone metabolism, this study seeks to provide a scientific basis for early screening and intervention of bone metabolism abnormalities in male T2DM patients, thereby improving their clinical outcomes.
Methods: This study analyzed 418 male T2DM inpatients from the Department of Endocrine and Metabolic Diseases at the First People's Hospital of Changzhou between May 2020 and May 2024. Patients were categorized into the pure T2DM group and the T2DM with OSAHS group based on their apnea-hypopnea index (AHI). Linear correlation and multiple linear regression analyses were employed to evaluate the relationships among OSAHS, BMI, and bone metabolism indicators. Finally, mediation analysis was conducted to assess the mediating effect of BMI.
Results: Among OSAHS indicators, nocturnal lowest oxygen saturation (LSaO2) correlated with total N-terminal propeptide of type I collagen (TP1NP). A 1-SD increase in LSaO2 was associated with a 2.532 ng/ml increase in TP1NP (95% CI: 0.232 ~ 4.832, P < 0.05). While BMI was positively correlated with bone mineral density (BMD), no correlation was found between BMI and bone turnover markers (BTMs). The oxygen desaturation index (ODI) and proportion of cumulative sleep time with oxygen saturation below 90% in total sleep time (T90) was initially correlated with BMD at the different sites, but the association was nullified after adjusting for BMI. Mediation analysis showed that BMI fully mediated the relationship between ODI T90 and BMD, with no influence on the association between LSaO2 and BTMs.
Conclusion: OSAHS-induced hypoxia may inhibit osteoblastic activity, which warrants further investigation. Additionally, while BMI fully mediates the relationship between ODI and BMD, further studies are needed to exclude the potential influence of BMI on BMD measurements.
期刊介绍：
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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