STUDY OBJECTIVES Obstructive sleep apnea (OSA) and low bone mineral density (BMD) are two prevalent conditions with a significant negative impact on patients' well-being and quality of life. Recent research consistently showed low BMD at different bone sites in male patients with OSA. Although the efficacy of continuous positive airway pressure (CPAP) treatment for OSA has been widely demonstrated, the evidence for understanding its impact on BMD and other bone-related outcomes is insufficient. The aim of this observational study was to investigate the effect of twelve months of CPAP treatment on lumbar and femur BMD and bone-related serum biomarkers in male patients with severe OSA. METHODS Sixty patients (mean age: 55.1±9.9 years) were consecutively included and underwent BMD measurement with dual-energy x-ray absorptiometry at baseline and after 12 months of CPAP treatment. Vitamin D, parathyroid hormone (PTH), and calcium serum levels were examined at the same time points. RESULTS Significant increase in BMD in the L1 (p<0.001, d=0.27) and L2 (p<0.001, d=0.26) vertebrae was observed after CPAP treatment, along with an increase in vitamin D (p<0.001, d=0.71) and calcium (p<0.001, d=0.73) levels and a decrease in PTH levels (p<0.001, d=0.60). The increase in BMD in L1 was significantly correlated with the decrease in PTH serum levels (r=-0.50, p<0.001). CONCLUSIONS Overall, these findings showed that beneficial OSA treatment might restore bone health, and support CPAP treatment as a feasible strategy to improve BMD in male patients with severe OSA. Accordingly, diagnosing and targeting OSA may be warranted in the treatment of male patients with undetermined osteopenia and osteoporosis.

中文翻译：

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持续气道正压通气治疗可改善患有严重阻塞性睡眠呼吸暂停综合征的男性的骨矿物质密度。

研究目标 阻塞性睡眠呼吸暂停 (OSA) 和低骨矿物质密度 (BMD) 是两种常见疾病，对患者的健康和生活质量产生显着的负面影响。最近的研究一致表明，患有 OSA 的男性患者不同骨部位的 BMD 较低。尽管持续气道正压通气 (CPAP) 治疗 OSA 的疗效已得到广泛证明，但了解其对 BMD 和其他骨骼相关结果影响的证据尚不充分。这项观察性研究的目的是调查 12 个月的 CPAP 治疗对患有严重 OSA 的男性患者腰椎和股骨 BMD 以及骨相关血清生物标志物的影响。方法 连续纳入 60 名患者（平均年龄：55.1±9.9 岁），并在基线时和 CPAP 治疗 12 个月后使用双能 X 射线骨密度仪进行 BMD 测量。在同一时间点检查维生素 D、甲状旁腺激素 (PTH) 和血清钙水平。结果 CPAP 治疗后观察到 L1（p<0.001，d=0.27）和 L2（p<0.001，d=0.26）椎骨的 BMD 显着增加，同时维生素 D 也增加（p<0.001，d=0.71） ）和钙（p<0.001，d=0.73）水平以及 PTH 水平下降（p<0.001，d=0.60）。L1 BMD 的增加与 PTH 血清水平的降低显着相关（r=-0.50，p<0.001）。结论 总体而言，这些研究结果表明，有益的 OSA 治疗可能会恢复骨骼健康，并支持 CPAP 治疗作为改善严重 OSA 男性患者 BMD 的可行策略。因此，在治疗患有未确定的骨质减少和骨质疏松症的男性患者时，可能需要诊断和针对 OSA。