Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?

AKYILDIZ, UTKU OGAN; Akyol, Asli

doi:10.4274/meandros.galenos.2023.72325

Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?

Utku Oğan AKYILDIZ, (Aydın Adnan Menderes Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Aydın, Türkiye)

Asli Akyol GURSES (Gazi Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Klinik Nörofizyoloji Anabilim Dalı, Ankara, Türkiye)

Meandros Medical And Dental Journal

6 1

Yıl: 2023 Cilt: 24 Sayı: 1 Sayfa Aralığı: 52 - 57 Metin Dili: İngilizce DOI: 10.4274/meandros.galenos.2023.72325 İndeks Tarihi: 01-06-2023

Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?

Öz:

Objective: The link between obstructive sleep apnea syndrome (OSAS) and hypothyroidism, which is associated with mucopolysaccharide infiltration and swelling of the soft tissues of the upper airway, is known for years. However, reports regarding the frequency of hypothyroidism in OSAS, as well as the requirement of screening thyroid stimulating hormone (TSH), have inconsistent results. This study aims to reveal the actual frequency of hypothyroidism among individuals with complaints suggestive of OSAS and provide a rationale for whether or not to screen. Materials and Methods: Two hundred eighty-two patients evaluated due to complaints suggesting OSAS and underwent overnight diagnostic polysomnography were retrospectively reviewed. Demographic, clinical, and polysomnographic parameters and serum TSH levels were analyzed and compared between OSAS patients and those with a normal apnea-hypopnea index (AHI). A multiple linear regression model was used to adjust for potential confounders. A two-tailed p-value of <0.05 was accepted as statistically significant. Results: No patient from the entire study population was diagnosed with overt hypothyroidism. Pairwise comparisons between OSAS patients and non-OSAS controls revealed similar results in terms of TSH levels (1.62 mIU/L vs 1.44 mIU/L, p=0.258) and subclinical hypothyroidism frequency (3.2% vs 3.4%, p=0.934). There was no association between the TSH levels and AHI values. Conclusion: According to these results, a TSH screen does not seem to be a mandatory part of routine workups in patients with sleep-disordered breathing symptoms for uncovering clinical hypothyroidism. Limiting TSH screening mainly to patients with marked symptoms regarding hypothyroidism would be appropriate in this population.

Anahtar Kelime:

Tıkayıcı Uyku Apne Sendromunda TSH Taraması: Faydasız ya da Faydalı?

Öz:

Amaç: Tıkayıcı uyku apne sendromu (TUAS) ve hipotiroidizm arasında yıllardan beri iyi tanımlanmış bir ilişki mevcuttur. Hipotiroidizmin üst solunum yollarını da içine alan yumuşak dokuda diffüz mukopolisakkarid birikimi üzerinden TUAS patofizyolojisine katkıda bulunduğu bilinmektedir. Bununla birlikte TUAS’de hipotiroidizmin sıklığı ve dolayısıyla da tiroid stimule edici hormon (TSH) taramasının gerekliliğini değerlendiren çalışmalarda çelişkili sonuçlar olduğu görülmektedir. Bu çalışmada amaç, TUAS şüphesiyle değerlendirilen hastalarda hipotiroidizmin gerçek sıklığını belirlemek ve bu popülasyonda TSH taramasının gerekli olup olmadığını ortaya koymaktır. Gereç ve Yöntemler: TUAS şüphesi ile değerlendirilerek bir gecelik tanısal polisomnografiye tabi tutulan 282 hastanın kayıtları geriye dönük incelendi. Olguların klinik, demografik, polisomnografik bulguları ve TSH düzeyleri kaydedilerek OSAS saptanan ve saptanmayan grupta karşılaştırıldı. TSH düzeyleriyle ilişkisi olabilecek potansiyel değişkenler için çoklu hiyerarşik regresyon modeli uygulandı. P<0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışma popülasyonundaki hiçbir olguda klinik hipotiroidizm saptanmadı. TUAS saptanan ve saptanmayan grupta TSH düzeyleri (1,62 mIU/L vs 1,44 mIU/L, p=0,258) ve subklinik hipotiroidizm oranlarının (%3,2 vs %3,4, p=0,934) benzer olduğu görüldü. TSH değerleri ile apne-hipopne indeksi arasında bir ilişki saptanmadı. Sonuç: Mevcut çalışmada elde edilen bulgular, uyku ilişkili solunum bozukluğu şüphesi ile değerlendirilen olgularda rutin TSH taramasının klinik hipotiroidizmi saptamak yönünden ek bir katkı sağlamadığını göstermektedir. Bu popülasyonda TSH taramasının, hipotiroidizmle ilişkili belirgin semptomlar tanımlayan olgularda tercih edilmesi uygun görünmektedir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	AKYILDIZ U, Akyol A (2023). Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. , 52 - 57. 10.4274/meandros.galenos.2023.72325
Chicago	AKYILDIZ UTKU OGAN,Akyol Asli Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. (2023): 52 - 57. 10.4274/meandros.galenos.2023.72325
MLA	AKYILDIZ UTKU OGAN,Akyol Asli Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. , 2023, ss.52 - 57. 10.4274/meandros.galenos.2023.72325
AMA	AKYILDIZ U,Akyol A Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. . 2023; 52 - 57. 10.4274/meandros.galenos.2023.72325
Vancouver	AKYILDIZ U,Akyol A Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. . 2023; 52 - 57. 10.4274/meandros.galenos.2023.72325
IEEE	AKYILDIZ U,Akyol A "Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?." , ss.52 - 57, 2023. 10.4274/meandros.galenos.2023.72325
ISNAD	AKYILDIZ, UTKU OGAN - Akyol, Asli. "Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?". (2023), 52-57. https://doi.org/10.4274/meandros.galenos.2023.72325

APA	AKYILDIZ U, Akyol A (2023). Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. Meandros Medical And Dental Journal, 24(1), 52 - 57. 10.4274/meandros.galenos.2023.72325
Chicago	AKYILDIZ UTKU OGAN,Akyol Asli Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. Meandros Medical And Dental Journal 24, no.1 (2023): 52 - 57. 10.4274/meandros.galenos.2023.72325
MLA	AKYILDIZ UTKU OGAN,Akyol Asli Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. Meandros Medical And Dental Journal, vol.24, no.1, 2023, ss.52 - 57. 10.4274/meandros.galenos.2023.72325
AMA	AKYILDIZ U,Akyol A Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. Meandros Medical And Dental Journal. 2023; 24(1): 52 - 57. 10.4274/meandros.galenos.2023.72325
Vancouver	AKYILDIZ U,Akyol A Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?. Meandros Medical And Dental Journal. 2023; 24(1): 52 - 57. 10.4274/meandros.galenos.2023.72325
IEEE	AKYILDIZ U,Akyol A "Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?." Meandros Medical And Dental Journal, 24, ss.52 - 57, 2023. 10.4274/meandros.galenos.2023.72325
ISNAD	AKYILDIZ, UTKU OGAN - Akyol, Asli. "Screening TSH in Obstructive Sleep Apnea Syndrome: Null or Beneficial?". Meandros Medical And Dental Journal 24/1 (2023), 52-57. https://doi.org/10.4274/meandros.galenos.2023.72325