Objective: We aimed to investigate any associations between serum total testosterone (TT) levels and inflammation markers, carbohydrate-bone metabolic status, or other clinical/laboratory sleep variables in severe obstructive sleep apnea (OSA).
Materials and Methods:Seventy-four men who underwent polysomnography tests at the sleep laboratory were included in the study. The patient group consisted of 44 people with severe OSA with Apnea Hypopnea Index (AHI) score ≥30, and the control group consisted of 30 people with AHI score <5. Cases in the severe OSA group were divided into two subgroups based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) median value and evaluated statistically.Results: Compared to the control group (395±101), TT was significantly lower in severe OSA (321±108), p=0.004. In severe OSA, TT was associated with biochemical parameters such as C-reactive protein (CRP), fibrinogen, HOMA-IR, and many sleep variables such as AHI, oxygen desaturation index, rapid eye movement (REM)-AHI, and Non-REM-AHI (p<0.05). After adjusting for body mass index and age variation, according to multiple linear regression analysis, TT was significantly related to the AHI score (β=−0.415, p=0.006). Compared to the control group, in the severe OSA group with HOMA-IR≥3.54, TT was found lower (p=0.001), systemic inflammatory response index, CRP, fibrinogen, Hemoglobin A1c, liver enzymes, and parathormone were found higher (p<0.05).
Conclusion:TT was associated with OSA severity, inflammation status, insulin resistance, and hypoxia. An independent relation was found between the severity of OSA and TT. Since testosterone deficiency could have a negative impact on sleep quality, it is important to measure TT level in OSA.