Vitamin D Status and Parathyroid Hormone Levels in Patients with Obstructive Sleep Apnea

Abstract

Background: Vitamin D insufficiency and high levels of parathyroid hormone (PTH) appear to be emerging risk factors for metabolic syndrome (MS), diabetes and cardiovascular disease, conditions that occur frequently in patients with obstructive sleep apnea syndrome (OSAS). Objectives: This study examined whether serum concentrations of 25-hydroxyvitamin D [25(OH)D] and PTH were associated with the presence of MS, diabetes and hypertension among an OSAS population. Methods: A total of 826 patients (635 men and 191 women) with newly diagnosed OSAS were studied. The occurrence of the MS was analyzed according to the National Cholesterol Education Program Adult Treatment Panel III clinical criteria. Serum levels of 25(OH)D, PTH, glucose, triglycerides, cholesterol, HDL cholesterol, creatinine and uric acid were determined. Results: In 55.3% of the men and in 63.2% of the women, the serum 25(OH)D level was less than 30 ng/ml (insufficient status). After adjusting for age, sex and seasonality, there was a significant trend of decreasing odds for diabetes [odds ratio (OR) 0.55, 95% confidence interval (CI) 0.33-0.94, p_trend = 0.038] and MS (OR 0.34, 95% CI 0.21-0.56, p_trend < 0.001) with increasing vitamin D levels. Higher PTH levels were associated with a higher prevalence of obesity (OR 2.05, 95% CI 1.06-3.09, p_trend< 0.001) and hypertension (OR 1.83, 95% CI 1.01-3.05, p_trend= 0.049). Conclusions: These data suggest an inverse association of 25(OH)D with diabetes and MS and a positive association of PTH with obesity and hypertension among patients with OSAS. Based on our observational study, the causative nature of the associations cannot be established. These findings require further examination in prospective studies including clinical trials.

Continuous Positive Airway Pressure Treatment Increases Serum Vitamin D Levels in Male Patients with Obstructive Sleep Apnea

“…[3][4][5][6] The novel contribution of the current study lies in the observation that a short-term treatment with nCPAP promotes the improvement of the vitamin D homeostasis in male patients with OSA. In fact, nCPAP is the treatment of choice to improve several internal parameters in patients with OSA.…”

“…[3][4][5][6] Vitamin D and PTH participate in bone metabolism and calcium homeostasis. Additionally, vitamin D has pleiotropic effects, modulating numerous metabolic processes in multiple tissues throughout the body.…”

Association Between Elevated Serum Uric Acid and Vitamin D Insufficiency Among the Middle-Aged and Elderly Population

“…Whether elevated serum uric acid levels are associated with low 25(OH)D levels remains controversial. Whereas some published data indicate that elevated uric acid levels are inversely related to 25(OH)D levels (12), other studies have shown no such association (13). Thus, we aimed to investigate the potential association of serum uric acid and 25(OH)D levels.…”

Vitamin D Improves Selected Metabolic Parameters but Not Neuropsychological or Quality of Life Indices in OSA: A Pilot Study

“…[6][7][8] We and others have observed widespread vitamin D OSA. [9][10][11][12][13][14] Interestingly, 25(OH)D levels have been shown to be inversely correlated with OSA severity 10,11,13 and with metabolic alterations associated with OSA, including abnormal glucose metabolism 11,12 and nocturnal heart rate.…”

“…[6][7][8] A recent study suggested that the association between lower 25(OH) D and OSA was largely confounded by larger BMI and neck circumference. 9 In contrast, our group 10 and others [11][12][13][14] have reported a high rate of vitamin D deficiency in OSA, where vitamin D levels (25(OH)D) are lower in severe OSA 10,11,13 and inversely correlate with some of its associated metabolic alterations, including abnormal glucose metabolism 11,12 as well as nocturnal heart rate. 10 Vitamin D receptors are located systemically and recent advances have demonstrated the potential of vitamin D to influence a wide variety of organs.…”