Bone Loss in Obesity and Obstructive Sleep Apnea: A Review of Literature

Chakhtoura, Marlene; Nasrallah, Mona; Chami, Hassan

doi:10.5664/jcsm.4708

Cited by 18 publications

(7 citation statements)

References 60 publications

(67 reference statements)

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“…The repetitive hypoxia and subsequent reoxygenation that occur in OSA may lead to oxidative stress, which may result in acidosis because of insufficient vascular perfusion [ 7 ]. Furthermore, hypoxia may inhibit the proliferation of osteoblasts and promote proliferation of osteoclasts, resulting in osteoporosis [ 7 , 14 ]. A decrease in BMD caused by the above-mentioned mechanisms may increase the fragility fracture risk in the elderly.…”

Section: Discussionmentioning

confidence: 99%

Increased fragility fracture risk in Korean women who snore: a 10-year population-based prospective cohort study

Seung-Hun

Lyu

Lee

et al. 2017

BMC Musculoskelet Disord

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BackgroundSnoring is frequently associated with obstructive sleep apnea (OSA). Previous studies have shown that bone mineral density was significantly lower in patients with OSA than in controls; however, these studies did not focus on fractures. Fragility fractures can lead to long-term disabilities and a decrease in quality of life. The present study aimed to investigate the association between snoring and fragility fractures.MethodsThis study included 2969 men and 3220 women aged 40 years and older from the Ansung and Ansan cohort studies in Korea. During a 10-year follow-up period, 129 and 273 fracture cases were reported in men and women, respectively.ResultsSevere snoring (6–7 nights per week or sleep disturbance by snoring in the next room) was a statistically significant risk factor for fracture (p = 0.006, hazard ratio 1.68, 95% confidence interval 1.16–2.43) after adjusting for covariates related to fragility fracture in women. However, both snoring and severe snoring groups did not show significant associations with the fracture risk in men.ConclusionsThus, information on the frequency of snoring in women may improve the accuracy of fragility fracture risk prediction, which can help in deciding whether intervention or treatment is necessary.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1587-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Increased fragility fracture risk in Korean women who snore: a 10-year population-based prospective cohort study

Seung-Hun

Lyu

Lee

et al. 2017

BMC Musculoskelet Disord

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“…Furthermore, the bone turnover markers osteocalcin and β ‐CTx have also been shown to be reduced in OSA compared with controls (Terzi and Yilmaz, ; Tomiyama et al ., ). Previous studies have considered whether OSA can affect bone turnover and lead to bone loss through various mechanisms, including hypoxia (Chakhtoura et al ., ). In addition, the bone formation marker, osteocalcin, has been correlated with glucose metabolism (Brennan‐Speranza and Conigrave, ).…”

Section: Introductionmentioning

confidence: 97%

Changes of vitamin D levels and bone turnover markers after CPAP therapy: a randomized sham‐controlled trial

Theorell‐Haglöw

Hoyos

Phillips

et al. 2017

Journal of Sleep Research

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The aim was to investigate whether continuous positive airway pressure treatment could modulate serum vitamin D (25-hydroxyvitamin D) and bone turnover markers (collagen-type 1 cross-linked C-telopeptide, osteocalcin and N-terminal propeptide of type 1 collagen) in secondary analysis from a randomized controlled trial. Sixty-five continuous positive airway pressure-naïve male patients with obstructive sleep apnea (age = 49 ± 12 years, apnea-hypopnea index = 39.9 ± 17.7 events h , body mass index = 31.3 ± 5.2 kg m ) were randomized to receive either real (n = 34) or sham (n = 31) continuous positive airway pressure for 12 weeks. At 12 weeks, all participants received real continuous positive airway pressure for an additional 12 weeks. After 12 weeks of continuous positive airway pressure (real versus sham), there were no between-group differences for any of the main outcomes [Δ25-hydroxyvitamin D: -0.80 ± 5.28 ng mL (mean ± SE) versus 3.08 ± 3.66 ng mL , P = 0.42; Δcollagen-type 1 cross-linked C-telopeptide: 0.011 ± 0.014 ng mL versus -0.004 ± 0.009 ng mL , P = 0.48; Δosteocalcin: 1.13 ± 1.12 ng mL versus 0.46 ± 0.75 ng mL , P = 0.80; ΔN-terminal propeptide of type 1 collagen: 2.07 ± 3.05 μg L versus -1.05 ± 2.13 μg L , P = 0.48]. There were no further differences in subgroup analyses (continuous positive airway pressure-compliant patients, patients with severe obstructive sleep apnea or sleepy patients). However, after 24 weeks irrespective of initial randomization, vitamin D increased in patients with severe obstructive sleep apnea (9.56 ± 5.51 ng mL , P = 0.045) and in sleepy patients (14.0 ± 4.69 ng mL , P = 0.007). Also, there was a significant increase in osteocalcin at 24 weeks (3.27 ± 1.06 ng mL , P = 0.01) in compliant patients. We conclude that 12 weeks of continuous positive airway pressure did not modulate vitamin D or modulate any of the bone turnover markers compared with sham. However, it is plausible that continuous positive airway pressure may have late beneficial effects on vitamin D levels and bone turnover markers in selected groups of patients with obstructive sleep apnea.

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“…[2][3][4] Additionally, OSAS has been associated with multiple metabolic disturbances including excess systemic inflammation, hyperglycemia, hyperlipidemia, cardiovascular disease, and increased bone loss. 5,6 Vitamin D receptors and enzymes have been discovered in most cell types and tissues leading to the realization that vitamin D exerts non-skeletal, pleiotropic effects in multiple organs. 7 However, vitamin D deficiency (VDD) remains highly prevalent worldwide.…”

Section: Introductionmentioning

confidence: 99%

Serum Vitamin D Is Significantly Inversely Associated with Disease Severity in Caucasian Adults with Obstructive Sleep Apnea Syndrome

Kerley

Hutchinson

Bolger

et al. 2016

Sleep

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We observed widespread vitamin D deficiency and insufficiency in a Caucasian, OSAS population. There were significant, independent, inverse relationships between 25(OH)D and AHI as well as nocturnal HR, a known cardiovascular risk factor. Further, 25(OH)D was significantly lower in OSAS cases compared to matched, non-OSAS subjects. We provide evidence that 25(OH)D and OSAS are related, but the role, if any, of replenishment has not been investigated.

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Bone Loss in Obesity and Obstructive Sleep Apnea: A Review of Literature

Cited by 18 publications

References 60 publications

Increased fragility fracture risk in Korean women who snore: a 10-year population-based prospective cohort study

Increased fragility fracture risk in Korean women who snore: a 10-year population-based prospective cohort study

Changes of vitamin D levels and bone turnover markers after CPAP therapy: a randomized sham‐controlled trial

Serum Vitamin D Is Significantly Inversely Associated with Disease Severity in Caucasian Adults with Obstructive Sleep Apnea Syndrome

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