阻塞性睡眠呼吸暂停综合征患者血清性激素水平临床特点分析

Clinical characteristics of serum sex hormone levels in patients with obstructive sleep apnea syndrome

目的探讨男性阻塞性睡眠呼吸暂停综合征(OSAS)患者血清性激素水平的临床特点。方法选取2017年1月至2020年6月江苏大学附属人民医院睡眠中心初次诊断为OSAS的193例成年男性患者作为OSAS组,另选取89名体检健康排除OSAS的男性作为对照组。分别检测血清睾酮(T)、雌二醇(E_(2))、黄体生成素(LH)、卵泡刺激素(FSH)、催乳素(PRL)和孕酮(P)水平,对比分析OSAS患者血清性激素水平的临床特点。结果轻度OSAS患者性激素水平与正常人群无明显差异(P>0.05),中度和重度OS-AS患者体内T水平低于正常人群(P<0.01),重度OSAS患者E_(2)水平高于正常人群(P<0.05),其余激素则与正常人群无明显差异(P>0.05)。血清T水平和体重指数(BMI)、呼吸暂停低通气指数(AHI)、氧减饱和度指数(ODI)呈负相关(P<0.05),而血清E_(2)则与BMI呈正相关(P<0.05)。合并肥胖的OSAS患者T水平较正常人群低(P<0.01),而E_(2)和PRL水平则高于正常人群(P<0.05)。结论中度和重度OSAS男性患者体内T水平与正常人群相比偏低,E_(2)水平偏高。可能与OSAS患者睡眠间断性缺氧导致的下丘脑-垂体-睾丸轴激素反馈调节紊乱有关。T与OSAS患者的病情严重程度呈负相关,合并肥胖的OSAS患者体内性激素紊乱则更为明显。

Objective To investigate the clinical characteristics of serum sex hormone levels in male patients with obstructive sleep apnea syndrome(OSAS).Methods 193 adult male patients who were initially diagnosed with OSAS in the Sleep Center of Jiangsu University Affiliated People Hospital from January 2017 to June 2020 were selected as the OSAS group,and another 89 healthy men who were excluded from OSAS were selected as the control group.Serum levels of testosterone(T),estradiol(E_(2)),luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL)and progesterone(P)were measured separately to analyze the clinical characteristics of serum sex hormone levels in patients with OSAS.Results There was no significant difference in sex hormone levels between the mild OSAS group and the normal group(P>0.05),patients in the moderate and severe OSAS group had lower testosterone levels than the normal group(P<0.01),and the severe OSAS group had higher estradiol level than the normal group(P<0.05).Serum testosterone levels showed a statistically significant negative correlation with BMI,AHI,and ODI(P<0.05),whereas serum estradiol showed a statistically significant positive correlation with BMI(P<0.05).OSAS patients with combined obesity had lower testosterone levels than the normal group(P<0.01),while estradiol and prolactin levels were higher than the normal group(P<0.05).Conclusions T levels in male patients with moderate and severe OSAS were lower and E_(2) levels were higher than those in the normal population.It may be related to the disorder of hypothalamic-pituitary-testicular axis hormone feedback regulation caused by sleep discontinuous hypoxia in OSAS patients.T was negatively correlated with the severity of OSAS patients,and the sex hormone disorder in OSAS patients with obesity was more obvious.