Introduction

This study aimed to synthesize existing evidence on the potential association between obstructive sleep apnea (OSA) and low bone mass in adults.

Methods

Electronic searches of four main databases were performed. The inclusion criteria consisted of observational studies investigating the relationship between OSA and bone mass, osteoporosis, fractures, or bone metabolism markers in adult population. Bone mineral density (BMD) and T score of lumbar and femur neck, incidence of osteoporosis and fractures, bone metabolism marker levels were extracted as primary outcomes.

Results

Among the 693 relevant publications, 10 studies consisting of 158,427 participants met with the inclusion and exclusion criteria. Meta-analysis showed a significant lower BMD of lumbar (mean difference (MD) = − 0.03; 95% CI − 0.05, − 0.01; I² = 46%), femur neck (MD = − 0.06; 95% CI − 0.12, 0.00; I² = 71%), and a significant lower T score of lumbar (MD = − 0.42; 95% CI − 0.79, − 0.05; I² = 63%) in the OSA group. The results suggested that both male (odds ratio (OR) = 2.03; 95% CI 1.23, 3.35; I² = 38%) and female (OR = 2.56; 95% CI 1.96, 3.34; I² = 0%) had higher risk of osteoporosis in the OSA group. Besides, meta-analysis also showed that bone-specific alkaline phosphatase was significantly lower in OSA patients (MD = − 1.90; 95% CI − 3.48, − 0.32; I² = 48%).

Conclusions

A potential association between OSA and lower bone mass in adults is preliminarily proved. It also seems plausible that both male and female with OSA have a higher risk of osteoporosis.

中文翻译：

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成人阻塞性睡眠呼吸暂停与低骨量之间的关联：系统评价和荟萃分析

介绍

本研究旨在综合现有证据，证明成人阻塞性睡眠呼吸暂停 (OSA) 与低骨量之间的潜在关联。

方法

对四个主要数据库进行了电子检索。纳入标准包括观察性研究，调查成人中 OSA 与骨量、骨质疏松症、骨折或骨代谢标志物之间的关系。提取腰椎和股骨颈的骨矿物质密度（BMD）和T评分、骨质疏松和骨折的发生率、骨代谢标志物水平作为主要结果。

结果

在 693 篇相关出版物中，10 项由 158,427 名参与者组成的研究符合纳入和排除标准。荟萃分析显示腰椎（平均差 (MD) = − 0.03；95% CI − 0.05，− 0.01；I 2 = 46%）、股骨颈（^MD  = − 0.06；95% CI − 0.12， OSA 组的腰椎 T 评分显着降低（MD = − 0.42；95% CI − 0.79，− 0.05；I 2 = ⁶³  % ）^。结果表明，男性（优势比 (OR) = 2.03；95% CI 1.23, 3.35；I ²  = 38%）和女性（OR = 2.56；95% CI 1.96, 3.34；I ² = 0%）在 OSA 组中骨质疏松症的风险较高。此外，荟萃分析还显示，OSA患者的骨特异性碱性磷酸酶显着降低（MD = − 1.90；95% CI − 3.48，− 0.32；I ²  = 48%）。

结论

初步证明 OSA 与成人低骨量之间存在潜在关联。患有 OSA 的男性和女性都有更高的骨质疏松症风险，这似乎也是合理的。