Turkish Journal of Geriatrics 2012 , Vol 15, Issue 2
RELATIONSHIP BETWEEN NON-THYROIDAL ILLNESS SYNDROME AND OBSTRUCTIVE SLEEP APNEA SYNDROME
Hikmet FIRAT1, Nujen ÇOLAK2, Esra BİLGİN1, Erman ÇAKAL2, Melike YÜCEEGE1, Ahmet DEMİR3, Sadık ARDIÇ1, Tuncay DELİBAŞI2
1Sağlık Bakanlığı Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği ANKARA
2Sağlık Bakanlığı Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Endokrinoloji ve Metabolik Hastalıklar Kliniği ANKARA
3Hacettepe Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Anabilim Dalı ANKARA
Introduction: Obstructive sleep apnea syndrome(OSAS) and Non-Thyroidal Illness Syndrome(NTIS) are two separate disorders associated with inflammatory response to hypoperfusion/ hypoxia.We investigated the presence of NTIS in subjects with OSAS and the relationship between thyroid hormone levels and the severity of OSAS.

Materials and Method: Study group composed of 146 subjects (52 male, 94 female), who underwent polysomnography and grouped as non-OSAS (AHI<5, n=22), mild-OSAS (5≤AHI<15, n=49) and moderate-severe OSAS (AHI≥15, n=75). Thyroid ultrasound was performed and plasma levels of thyroid hormones,C-reactive protein (hs-CRP), anti-thyroglobulin and anti-thyroid peroxidase antibodies were measured.

Results: Study population consisted of 146 subjects [52/94(F/M)] with a mean age of 45,9±9.8. Oxygen desaturation index (ODI), mean and minimum oxygen saturation (minSaO2), time spent under SaO2 of<90% and hs-CRP levels were statistically different between three groups (p<0.05). Ten patients (6F/4M; %13.3) were found to have NTIS, all of them were in the moderate-severe group. Serum average TSH, free-T3 and free-T4 levels were not significantly different (p>0.05) in OSAS patients compared to non-OSA subjects.Mean age and ODI were negatively correlated with free-T4 levels (r:-189, p<0.05), while minSaO2 was positively correlated with free-T4 levels.Only age was negatively correlated with free-T3 levels.

Conclusion: NTIS is more frequent in OSAS patients and associated with the severity of OSAS. NTIS may be a predicting factor for mortality and severity of OSAS.In order to show the relationship between NTIS and OSAS, further randomized controlled studies are needed before and after treatment of OSAS. Keywords : Aged; Euthyroid Sick Syndromes; Obstructive Sleep Apnea Syndrome