Men With OSA May Experience Early Bone Loss – Renal and Urology News

Men with obstructive sleep apnea (OSA) have lower volumetric bone mineral density (vBMD), trabecular thickness, and cortical thickness than men without OSA, according to a study in BMC Pulmonary Medicine.

Researchers assessed the association between OSA and osteoporosis through a cross-sectional study comparing peripheral blood indices and high-resolution peripheral quantitative computer tomography (HR-pQCT) parameters in men with OSA vs those without OSA.

Participants, enrolled from a sleep clinic between August 2017 and February 2019, were men with OSA aged 30 to 59 years and a body mass index (BMI) of 30 kg/m² or less.

The researchers obtained fasting blood samples, and all participants underwent nocturnal in-lab polysomnography. HR-pQCT measurement sites were the tibia and radius on the nondominant side.

A total of 90 men with OSA were included; 25 with mild OSA, 21 with moderate OSA, 34 with severe OSA, and 10 without OSA (ie, the control group). Participants’ average (SD) age was 47.13 (5.85) years, with no significant difference among the groups. The average BMI was 25.66 (2.09) kg/m², with BMI significantly higher in those with severe OSA vs the control group (P =.036) and mild OSA group (P =.021).

Among the HR‑pQCT parameters, no significant differences were observed on the distal radius. For the tibia, the 4 patient groups had significant differences in cortical area (CtAr) (F=4.797, P =.04), as the CtAr of the severe OSA group was significantly higher compared with the mild (P =.06) and moderate OSA groups (P =.048) in a pairwise comparison.

For vBMD, the 4 patient groups had statistical differences in total vBMD (F=2.990, P =.035) and external trabecular vBMD (F=3.696, P =.015). Patients with OSA had lower values than individuals in the control group. Only external trabecular vBMD in the mild OSA group was lower vs the control group (P =.025) in pairwise comparison.

Regarding bone microstructure, the 4 groups had significant differences in trabecular thickness (F=7.060, P =.000) and cortical thickness (F = 4.959, P =.003). The 3 OSA groups had lower mean values than the control group.

Alkaline phosphatase was positively associated with hypopnea index and percentage of total sleep time with SpO₂ less than 90%. Regarding the radius, age had a negative association with multiple radius indicators of BMD and microstructure. BMI had a positive association with multiple indicators and a negative correlation with trabecular separation (R= –0.261, P =.013).

For the sleep indicators, only apnea hypopnea index had a positive association with trabecular thickness (R=0.210, P =.047). Multiple parameters of the radius were correlated with sleep efficiency.

In regression analysis conducted on the bone turnover indicators and HR-pQCT indicators, none of the relevant indicators reflecting OSA severity was associated with the indicators of HR-pQCT.

Study limitations include the cross-sectional design and lack of assessment of some important confounders, such as nutritional status and exercise levles. Also, the sample size was relatively small and excluded women and individuals older than 59 years of age.

“This study found that OSA might negatively impact the osteogenesis process,” stated the researchers. “It manifested as a decrease in vBMD, tibial cortex, and bone trabecular thickness; this change has already appeared around middle age.”

This article originally appeared on Pulmonology Advisor