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Title: The differences in the relationship between obstructive sleep apnea severity and trabecular bone score in men and women with type 2 diabetes
Authors: Hataikarn Nimitphong
Nantaporn Siwasaranond
Chanika Sritara
Sunee Saetung
La or Chailurkit
Naricha Chirakalwasan
Boonsong Ongphiphadhanakul
Sirimon Reutrakul
Chulalongkorn University
University of Illinois at Chicago
King Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn University
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Keywords: Biochemistry, Genetics and Molecular Biology;Medicine
Issue Date: 1-Jun-2019
Citation: Journal of Clinical and Translational Endocrinology. Vol.16, (2019)
Abstract: © 2019 The Authors Aims: Type 2 diabetes mellitus (T2DM)and obstructive sleep apnea (OSA)may adversely affect bone. Gender is a well-established factor influencing bone health. We investigated the impact of OSA on bone mineral density (BMD)and trabecular bone score (TBS)in T2DM. Methods: Eighty-one T2DM patients [33 men and 48 women]participated. OSA was diagnosed using an overnight monitor, with its severity assessed by an apnea hypopnia index (pAHI). The measurements of hypoxia, including the percentage of total sleep time in which oxygen saturation remains below 90% (pT90), the oxygen desaturation index (pODI)and minimum O2 (min O2), were reported. Lumbar spine (L1-4)and femoral neck (FN)BMD were measured using dual-energy X-ray absorptiometry (DXA). TBS was computed from DXA images. Results: Sixty-five patients (80.2%)had OSA. pAHI, pT90, pODI and min O2 were not correlated to L1-4 BMD, FN BMD or TBS in all participants by multiple regression analyses adjusting for age, gender and BMI. However, an interaction between gender and pAHI, and gender and pODI were significantly associated with TBS (b = 0.003, p = 0.034 and b = 0.004, p = 0.046, respectively). We therefore reassessed an association between pAHI or pODI and TBS separately between men and women. After adjusting for age and BMI, more severe OSA (higher pAHI)and higher pODI significantly associated with lower TBS (b = −0.002, p = 0.034 and b = −0.003, p = 0.021, respectively)in men. On the other hand, higher pAHI non-significantly associated with better trabecular microarchitecture as indicated by higher TBS (b = 0.002, p = 0.059)in women. When considered only postmenopausal (n = 33), higher pAHI and higher pODI were significantly associated with higher TBS (b = 0.004, p = 0.003 and b = 0.004, p = 0.008, respectively). Conclusions: In T2DM patients, there is a complex interrelationship among OSA severity, gender and TBS. More severe OSA predicted lower TBS in men, but predicted higher TBS in postmenopausal women.
ISSN: 22146237
Appears in Collections:Scopus 2019

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