The association between severity of obstructive sleep apnea and prevalence of Hashimoto’s thyroiditis

Bozkurt, Nujen Çolak; Karbek, Başak; Çakal, Erman; Fırat, Hikmet; Özbek, Mustafa; Delibaşı, Tuncay

doi:10.1507/endocrj.ej12-0106

Cited by 25 publications

(29 citation statements)

References 28 publications

(38 reference statements)

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“…In this study, functional and ultrasonographic examination of the thyroid gland did not reveal any relationship between OSAS and thyroid disease [1]. Unlike the study of Bozkurt et al [2], there was no difference in Hashimoto disease frequency between OSAS group and control group. However, the study of Carratù et al revealed, compatible results with our study, that subclinical hypothyroidism and levothyroxine treatment did not change prevalence and severity of OSAS [3].…”

contrasting

confidence: 81%

Lack of association between OSAS and hypothyroidism

2013

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contrasting

confidence: 81%

Lack of association between OSAS and hypothyroidism

2013

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“…Authors of the study pointed out that screening for thyroid disorders, not only for hypothyroidism but also for auto-immune thyroid diseases in OSAHS patients may be of benefit for early diagnosis of a thyroid failure. What is more, they suggested that OSAHS may be a pathogenic factor for thyroid auto-immunity [23]. However, this statement is controversial and should be treated merely as a hypothesis and not a conclusion supported by results of the study.…”

Section: Association Of Osahs and Hypothyroidismmentioning

confidence: 90%

“…Bozkurt et al [23] conducted a study, on the prevalence of Hashimoto's thyroiditis (HT), the most prevalent cause of hypothyroidism in populations with adequate iodine supply, in 245 euthyroid individuals, who were suspected of having OSAHS. Diagnosis of HT was based on thyroid ultrasound and serum anti-thyroglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) antibodies.…”

Section: Association Of Osahs and Hypothyroidismmentioning

confidence: 99%

Obstructive Sleep Apnea Syndrome and Hypothyroidism—Merely Concurrence or Causal Association?

Kuczyński

Gabryelska

Mokros

et al. 2016

Advances in Respiratory Medicine

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The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients. Obstructive sleep apnea-hypopnea syndromeObstructive sleep apnea -hypopnea syndrome (OSAHS) is a chronic condition, characterized by recurrent pauses in breathing during sleep. In consequence, they lead to sleep fragmentation and intermittent hypoxemia. Decreased quality of sleep leads to excessive day time sleepiness, cognitive dysfunction and impaired work performance [1]. OSAHS contributes to systemic hypertension [2], cardiovascular diseases [3] and abnormalities in glucose metabolism [4]. The reported prevalence of OSAHS in adult population ranges from 4 to 7% in men, and from 2 to 5% in women [1,5]; with some subgroups of the population bearing higher risk [1]. It is a serious health problem considering high prevalence and its deleterious consequences, e.g. traffic accidents or all causes related morbidity and mortality [6−8]. Polysomnography is an acknowledged gold standard in OSAHS diagnostics. Clinical and sub-clinical hypothyroidismPrimary hypothyroidism is a condition, in which thyroxin levels in blood are reduced and are accompanied by increased levels of TSH as an effect of disruption of negative feedback mechanism. Thus, hypothyroidism is diagnosed when concentration of serum TSH exceeds 4.5 mIU/L and free T4 (FT4) concentration is below the reference range: 0.8−2.0 ng/dL (10.3−25.7 pmol/L). The reported prevalence of overt hypothyroidism

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“…Em relação ao índice da apneia/hipopneia (IAH) os pacientes foram agrupados na seguinte classificação: Normal (IAH < 5 eventos/hora), SAOS leve (IAH de 5 a 15 eventos/ hora), SAOS moderada (IAH de 16 a 30 eventos/hora), SAOS grave (IAH > 30 eventos/hora) (18) . Da mesma forma, em relação ao Índice de Massa Corporal (IMC) os pacientes foram agrupados de acordo com a classificação da OMS: peso ideal (18,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)9 Kg/m 2 ), sobrepeso (25, O gênero masculino predominou no Grupo com SAOS (71,5%), mas no Grupo sem SAOS houve predomínio do gênero feminino (57,2%), sendo esta diferença estatisticamente significante (p=0,0001). Em ambos os grupos houve maior prevalência de pacientes na faixa etária adulta e, em relação ao IMC, também em ambos os grupos, os pacientes com sobrepeso seguido daqueles com obesidade Grau I foram os mais prevalentes.…”

Section: Casuística E Métodosunclassified

“…Em relação ao gênero, mulheres com menos de 50 anos com quadro de hipotireoidismo prévio têm risco relativo (2,9) mais alto de desenvolverem SAOS (11) . De acordo com o descrito na literatura, 7,7% dos pacientes com hipotireoidismo e 1,5% dos controles apresentam obstrução importante das vias respiratórias superiores associada a episódios repetitivos de apneia do sono (12)(13) . Aproximadamente 2 a 3% dos pacientes com diagnóstico de apneia primária do sono, quando não submetidos às análises da função tireiodiana, são subdiagnosticados e tratados inapropriadamente como portadores de SAOS em decorrência da não detecção do hipotireoidismo.…”

Section: Introductionunclassified

Prevalência De Hipotireoidismo Em Pacientes Com Queixas De Distúrbios Respiratórios Relacionados Ao Sono

Bortoluzzi¹,

Carreira²,

Oliveira³

et al. 2016

ACS

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Conflito de interesses: NãoContribuição dos autores: TBB concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. YCVA concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. ACO concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. ICAS concepção e planejamento do projeto de pesquisa, obtenção ou análise/ interpretação dos dados, redação e revisão crítica. VBP concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. FDM concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. p=0,3258). Conclusão: A prevalência de hipotireoidismo clínico na população estudada foi maior que a determinada na população geral. Pacientes com sinais e sintomas similares tanto ao hipotireoidismo como a síndrome da apneia obstrutiva do sono podem se beneficiar da dosagem hormonal tireoidiana.Descritores: Síndromes da Apneia do Sono; Hipotireoidismo; Identidade de Gênero. Abstract Introduction:The obstructive sleep apnea syndrome is one of the most complex sleep disorders. The association between hypothyroidism and obstructive sleep apnea syndrome has been the focus of research due to the similarity of symptoms of both disorders. Objective: Determine the prevalence of hypothyroidism in patients complaining of sleep-related breathing disorders. Material and Methods: Two hundred reports from patients of both genders who were referred to first appointment at the Sleep Apnea Clinic of a tertiary center between 2013 and 2014, were revised. The following data were collected: age at time of polysomnography, serum concentration of free thyroxine (T4) and thyroid-stimulating hormone (TSH), body mass index (BMI) and apnea/hypopnea index (AHI). A retrospective cross-sectional case study. Results: A prevalence of 16.2% (21/130) of hypothyroidism in patients with obstructive sleep apnea syndrome was found and most of them were male, and 10% (7/70) of hypothyroidism in patients without obstructive sleep apnea syndrome and all of them (100%) were female (OR-1.734; CI95%-0.6979-4.308; χ 2 -0.96565; p=0.3258). Conclusion:The prevalence of clinical hypothyroidism in this population was higher than that determined in the general population. Patients with similar signs and symptoms of both hypothyroidism and obstructive sleep apnea syndrome might benefit from thyroid hormone tests.

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The association between severity of obstructive sleep apnea and prevalence of Hashimoto’s thyroiditis

Cited by 25 publications

References 28 publications

Lack of association between OSAS and hypothyroidism

Lack of association between OSAS and hypothyroidism

Obstructive Sleep Apnea Syndrome and Hypothyroidism—Merely Concurrence or Causal Association?

Prevalência De Hipotireoidismo Em Pacientes Com Queixas De Distúrbios Respiratórios Relacionados Ao Sono

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