肥胖对OSAHS患者甲状腺功能影响机制的研究进展

Mechanism of obesity influencing thyroid function in patients with obstructive sleep apnea hypopnea syndrome

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)属于临床医学中常见的睡眠病症,从相关研究报道来看,肥胖对该疾病的危险性是最高的。而该疾病与甲状腺功能之间的联系还不是十分明确,但是OSAHS患者中有一部分同时存在甲状腺功能减退情况,有学者认为这与普通人群甲状腺功能减退发生概率相差不大,同时也有学者认为OSAHS伴有肥胖患者、儿童OSAHS的甲状腺功能减退发生风险更高。目前,OSAHS患者肥胖对甲状腺功能的影响机制尚不清楚,可能一方面由于OSAHS患者在睡眠过程中容易反复出现呼吸暂停情况、低通气及微觉醒导致低氧,肥胖加重低氧,导致体内代谢紊乱,胰岛素抵抗、瘦素、脂联素等水平及功能变化、维生素D水平变化引起甲状腺功能改变,同时异常神经调节、炎性反应等亦可引起甲状腺功能改变;另外,肥胖本身也可导致甲状腺功能改变。本文探讨肥胖对OSAHS患者甲状腺功能影响机制。

Obstructive sleep apnea hypopnea syndrome(OSAHS),also known as obstructive sleep apnea hypopnea syndrome,is a common sleep disorder in clinical medicine.According to relevant research reports,obesity is the highest risk factor for OSAHS.The relationship between the disease and thyroid function is not very clear,but some patients with OSAHS have hypothyroidism at the same time.Some scholars believe that this is not different from the incidence of hypothyroidism in the general population.At the same time,some scholars believe that obese patients with OSAHS and children with OSAHS have high risk of hypothyroidism.At present,the influence mechanism of obesity on thyroid function in OSAHS patients is still unclear.OSAHS patients are prone to recurrent apnea,hypoventilation,and micro arousal during sleep,leading to hypoxia.Obesity aggravates hypoxia and causes metabolic disorder,insulin resistance,and leptin,adiponectin,and functional changes.The change of vitamin D level can cause the change of thyroid function.Abnormal nerve regulation and inflammatory reaction can cause the change of thyroid function.In addition,obesity itself can also lead to changes in thyroid function.This article explores the mechanism of obesity on thyroid function in patients with OSAHS.