Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Respiratory Research
Published in: Respiratory Research 1/2020

01-12-2020 | Sleep Apnea | Research

The association between serum vitamin D and obstructive sleep apnea: an updated meta-analysis

Authors: Xiaoyan Li, Jie He, Jie Yun

Published in: Respiratory Research | Issue 1/2020

Login to get access

Abstract

Background

The objective was to determine whether OSA patients have a low serum vitamin D level by systematic review and meta-analysis.

Methods

This study searched the following electronic bibliographic databases: Embase, Medline, Web of Science, PubMed, VIP, Wanfang, CNKI and SinoMed. All data were searched between January 2000 and August 2020. The quality of the included studies was estimated by two researchers according to the Newcastle–Ottawa Scale and Agency for Healthcare Research and Quality. All qualified studies and statistical analyses were conducted using RevMan 5.2.

Results

Twenty-nine eligible studies compromising 6717 participants met the inclusion criteria of the meta-analysis. The results revealed that the serum 25(OH)D level was significantly lower in OSA patients than the controls. According to the severity of the disease, subgroup analysis was performed; the results demonstrated that the serum 25(OH)D level was not decreased in mild OSA patients compared with the controls, while the serum 25(OH)D level in moderate and severe OSA patients was lower than that in the controls. Furthermore, based on ethnicity, BMI, PSG type, study quality and latitude, the subjects were divided into different subgroups for meta-analysis. The results revealed that the serum 25(OH)D level in all OSA subgroups was decreased compared with that in the control group.

Conclusions

The present meta-analysis shows that the serum vitamin D level was different between OSA patients and healthy people. OSA patients could have a low serum vitamin D level.
Literature
1.
Kuna ST. Optimizing chronic management of adults with obstructive sleep apnea. Ann Am Thorac Soc. 2020;17(3):280–1. PubMedCrossRef
2.
Rowley JA, Lareau S, Fahy BF, Garvey C, Sockrider M. What is obstructive sleep apnea in adults. Am J Respir Crit Care Med. 2017;196(1):P1–2. PubMedCrossRef
3.
Kahal H, Tahrani A, Kyrou I, Dimitriadis GK, Kimani PK, Barber TM, et al. The relationship between obstructive sleep apnoea and quality of life in women with polycystic ovary syndrome: a cross-sectional study. Ther Adv Endocrinol Metab. 2020;11:2042018820906689. PubMedPubMedCentralCrossRef
4.
Toledo-Pons N, Alonso-Fernandez A, de Pena M, Pierola J, Barceló A, Fernández-Capitán C. Obstructive sleep apnea is associated with worse clinical-radiological risk scores of pulmonary embolism. J Sleep Res. 2019;1:e12871.
5.
Oh MS, Bliwise DL, Smith AL, Economou NT, Adamide T, Trakada G. Obstructive sleep apnea, sleep symptoms, and their association with cardiovascular disease. Laryngoscope. 2019;130(6):1595–602. PubMedCrossRef
6.
Arnardottir ES, Bjornsdottir E, Olafsdottir KA, Benediktsdottir B, Gislason T. Obstructive sleep apnoea in the general population: highly prevalent but minimal symptoms. Eur Respir J. 2016;47(1):194. PubMedCrossRef
7.
Liu MG, Zhang J, Liu GZ. Obstructive sleep apnea syndrome and ischemic stroke. J Stroke Neurol Dis. 2020;36(11):1042–5.
8.
Jones G. Extrarenal vitamin D activation and interactions between vitamin D (2), vitamin D (3), and vitamin D analogs. Annu Rev Nutr. 2013;33:23–44. PubMedCrossRef
9.
Kerley CP, Hutchinson K, Bolger K, McGowan A, Faul J, Cormican L. Serum vitamin D is significantly inversely associated with disease severity in caucasian adults with obstructive sleep apnea syndrome. Sleep. 2016;39(2):293–300. PubMedPubMedCentralCrossRef
10.
Mete T, Yalcin Y, Berker D, Ciftci B, Guven SF, Topaloglu O, et al. Obstructive sleep apnea syndrome and its association with vitamin D deficiency. J Endocrinol Invest. 2013;36(9):681–5. PubMed
11.
Yassa OY, Domac SF, Kenangil G. Serum vitamin D status does not correlate with the severity of obstructive sleep apnea in male adults: a controlled study design with minimized factors influencing serum vitamin D levels. Int J Vitam Nutr Res. 2019;1:1–7.
12.
Neighbors CLP, Noller MW, Song SA, Zaghi S, Neighbors J, Feldman D, et al. Vitamin D and obstructive sleep apnea: a systematic review and meta-analysis. Sleep Med. 2018;43:100–8. PubMedCrossRef
13.
14.
Zeng XT, Liu H, Chen X, Leng WD. Meta-analysis series 4: quality evaluation of observational studies Price tool. Chin J Evid Based Cardiovasc Med. 2012;4:297–9.
15.
Bozkurt NC, Cakal E, Sahin M, Ozkaya EC, Firat H, Delibasi T. The relation of serum 25-hydroxyvitamin-D levels with severity of obstructive sleep apnea and glucose metabolism abnormalities. Endocrine. 2012;41(3):518–25. PubMedCrossRef
16.
17.
Erden ES, Genc S, Motor S, Ustun I, Ulutas KT, Bilgic HK, et al. Investigation of serum bisphenol A, vitamin D, and parathyroid hormone levels in patients with obstructive sleep apnea syndrome. Endocrine. 2014;45(2):311–8. PubMedCrossRef
18.
Liguori C, Romigi A, Izzi F, Mercuri NB, Cordella A, Tarquini E, et al. Continuous positive airway pressure treatment increases serum vitamin D levels in male patients with obstructive sleep apnea. J Clin Sleep Med. 2015;11(6):603–7. PubMedPubMedCentralCrossRef
19.
Yang HH, Long F, Zhu N, Zhang X, Li SQ. Serum vitamin D levels in patients with chronic obstructive pulmonary disease combined with obstructive sleep apnea hypopnea syndrome. World clinical medicine. 2015;36(06):384–7.
20.
Goswami U, Ensrud KE, Paudel ML, Redline S, Schernhammer ES, Shikany JM, et al. Vitamin D concentrations and obstructive sleep apnea in a multicenter cohort of older males. Ann Am Thorac Soc. 2016;13(5):712–8. PubMedPubMedCentralCrossRef
21.
Zicari AM, Occasi F, Di Mauro F, Lollobrigida V, Di Fraia M, Savastano V, et al. Mean platelet volume, vitamin D and C reactive protein levels in normal weight children with primary snoring and obstructive sleep apnea syndrome. PLoS ONE. 2016;11(4):e0152497. PubMedPubMedCentralCrossRef
22.
Klobucnikova K, Siarnik P, Sivakova M, Wágnerová H, Mucska I, Kollár B. Carotid intima-media thickness is not associated with homocysteine and vitamin D levels in obstructive sleep apnea. Scand J Clin Lab Invest. 2017;77(4):263–6. PubMedCrossRef
23.
Toujani S, Kaabachi W, Mjid M, Hamzaoui K, Cherif J, Beji M. Vitamin D deficiency and interleukin-17 relationship in severe obstructive sleep apnea-hypopnea syndrome. Ann Thorac Med. 2017;12(2):107–13. PubMedPubMedCentralCrossRef
24.
Salepci B, Caglayan B, Nahid P, Parmaksiz ET, Kiral N, Fidan A, et al. Vitamin D deficiency in patients referred for evaluation of obstructive sleep apnea. J Clin Sleep Med. 2017;13(4):607–12. PubMedPubMedCentralCrossRef
25.
Archontogeorgis K, Nena E, Papanas N, Zissimopoulos A, Voulgaris A, Xanthoudaki M. Vitamin D levels in middle-aged patients with obstructive sleep apnoea syndrome. Curr Vasc Pharmacol. 2018;16(3):289–97. PubMedCrossRef
26.
Liguori C, Izzi F, Mercuri NB, Romigi A, Cordella A, Tarantino U, et al. Vitamin D status of male OSAS patients improved after long-term CPAP treatment mainly in obese subjects. Sleep Med. 2017;29:81–5. PubMedCrossRef
27.
Zhang LJ, Lin L, Hu MF, Xu QZ. Association between obstructive sleep apnea hypopnea syndrome and vitamin D in non-obese patients. J Mudanjiang Med Coll. 2017;38(05):41–4.
28.
Zhu ZH, Jiang XZ, Gu PL, Zhou B, Xu LY, Zou YF, et al. Effect of OSAHS on 25-hydroxyvitamin D3 in non-elderly patients with type 2 diabetes. Int J Respir Sci. 2017;37(19):1472–5.
29.
Liu CY, Xie WG, Tang LF, Zhao HD. Changes of serum vitamin D levels in patients with obstructive sleep apnea hypopnea syndrome with type 2 diabetes. J Clin Pulmon Sci. 2017;22(06):1137–8.
30.
Liu T, Wang Y, Li YZ. Significance of serum vitamin D detection in children with obstructive sleep apnea hypopnea syndrome. J Ear Nose Throat Eye Shandong Univ. 2017;31(01):21–6.
31.
Archontogeorgis K, Nena E, Papanas N, Rizzo M, Voulgaris A, Xanthoudaki M, et al. Metabolic syndrome and vitamin D levels in patients with obstructive sleep apnea syndrome. Metab Syndr Relat Disord. 2018;16(4):190–6. PubMedCrossRef
32.
Han JF, Jiang B. Changes of serum vitamin D levels in patients with obstructive sleep apnea hypopnea syndrome and their correlation with disease severity. J Pract Cardio-cerebrovasc Dis. 2018;26(10):46–9.
33.
Ou YW. Changes in bone metabolism in patients with type 2 diabetes mellitus complicated with sleep apnea hypopnea syndrome. Chin J Modern Med. 2019;13(11):49–50.
34.
Fan Z, Cao B, Long H, Feng L, Li Q, Zhang Y, et al. Independent association of vitamin D and insulin resistance in obstructive sleep apnea. Ann Endocrinol (Paris). 2019;80(5–6):319–23. CrossRef
35.
Ragia G, Archontogeorgis K, Simmaco M, Gentile G, Borro M, Zissimopoulos A, et al. Genetics of obstructive sleep apnea: vitamin D receptor gene variation affects both vitamin d serum concentration and disease susceptibility. OMICS. 2019;23(1):45–53. PubMedCrossRef
36.
Kirac D, Yagcioglu YO, Gezmis H, Mayda Domac SF, Altunok EC, Genc E. Different VDR, VDBP genotypes and vitamin D levels may effect obstructive sleep apnea syndrome. Cell Mol Biol (Noisy-le-grand). 2019;65(1): 46–51.
37.
Archontogeorgis K, Papanas N, Rizos EC, Nena E, Zissimopoulos A, Tsigalou C, et al. Reduced serum vitamin D levels are associated with insulin resistance in patients with obstructive sleep apnea syndrome. Medicina (Kaunas). 2019;55:5. CrossRef
38.
Bouloukaki I, Tsiligianni I, Mermigkis C, Bonsignore MR, Markakis M, Pataka A, et al. Vitamin D deficiency in patients evaluated for obstructive sleep apnea: is it associated with disease severity? Sleep Breath. 2020; 10(7).
39.
Siachpazidou DI, Kotsiou OS, Stavrou V, Pastaka C, Gogou E, Kechagia M, et al. Serum vitamin D levels in patients with obstructive sleep apnea syndrome and level changes after continuous positive airway pressure therapy. Sleep Breath. 2020;01:8.
40.
Ma D, Zheng X, Dong L, Zheng C, Chen Y, Chen Z, et al. The Relationship of serum 25-hydroxyvitamin-D level with severity of obstructive sleep apnea in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2020;13:1391–8. PubMedPubMedCentralCrossRef
41.
Nie L, Xu J, Chen JM, Li YL. Meta analysis of obstructive sleep apnea syndrome with hypertension and angiotensin converting enzyme gene polymorphism. Clin Med. 2016;36(07):10–2.
42.
Bonnet L, Hachemi MA, Karkeni E, Couturier C, Astier J, Defoort C, et al. Diet induced obesity modifies vitamin D metabolism and adipose tissue storage in mice. J Steroid Biochem Mol Biol. 2019;01:185.
43.
Bizzaro G, Antico A, Fortunato A, Bizzaro N. Vitamin D and autoimmune diseases: is vitamin D receptor (VDR) polymorphism the culprit. Isr Med Assoc J. 2017;19(7):438–43. PubMed
44.
Mazzaferro S, Goldsmith D, Larsson TE, Massy ZA, Cozzolino M. Vitamin D metabolites and/or analogs: which D for which patient. Curr Vasc Pharmacol. 2014;12(2):339–49. PubMedCrossRef
45.
Vieira WA, Wells KM, Milgrom R, McCusker CD. Exogenous Vitamin D signaling alters skeletal patterning, differentiation, and tissue integration during limb regeneration in the axolotl. Mech Dev. 2018;153:1–9. PubMedPubMedCentralCrossRef
46.
Jean G, Souberbielle JC, Chazot C. Vitamin D in chronic kidney disease and dialysis patients. Nutrients. 2017;9:4. CrossRef
47.
Herrero BA, de Koninck BP, Beetz G, De Beaumont L, Martel MO, Lavigne GJ. Sleep and pain: recent insights, mechanisms, and future directions in the investigation of this relationship. J Neural Transm (Vienna). 2019;127(4):647–60. CrossRef
48.
Moradi H, Sohrabi M, Taheri H, Khodashenas E, Movahedi A. The effects of different combinations of perceptual-motor exercises, music, and vitamin D supplementation on the nerve growth factor in children with high-functioning autism. Complement Ther Clin Pract. 2018;31:139–45. PubMedCrossRef
49.
Yong CY, Reynaud E, Forhan A, Dargent-Molina P, Heude B, Charles MA, et al. Cord-blood vitamin D level and night sleep duration in preschoolers in the EDEN mother-child birth cohort. Sleep Med. 2019;53:70–4. PubMedCrossRef
50.
Medrano M, Carrillo-Cruz E, Montero I, Perez-Simon JA. Vitamin D: Effect on haematopoiesis and immune system and clinical application. Int J Mol Sci. 2018;19:9. CrossRef
51.
Trochoutsou AI, Kloukina V, Samitas K, Xanthou G. Vitamin-D in the Immune System: Genomic and Non-Genomic Actions. Mini Rev Med Chem. 2015;15(11):953–63. PubMedCrossRef
52.
53.
Song J, Li Y, An R. Vitamin D restores angiogenic balance and decreases tumor necrosis factor-alpha in a rat model of pre-eclampsia. J Obstet Gynaecol Res. 2017;43(1):42–9. PubMedCrossRef
54.
Nourhashemi F, Hooper C, Cantet C, Féart C, Gennero I, Payoux P, et al. Cross-sectional associations of plasma vitamin D with cerebral beta-amyloid in older adults at risk of dementia. Alzheimers Res Ther. 2018;10(1):43. PubMedPubMedCentralCrossRef
55.
Kerley CP, Hutchinson K, Bramham J, McGowan A, Faul J, Cormican L. Vitamin D improves selected metabolic parameters but not neuropsychological or quality of life indices in OSA: a pilot study. J Clin Sleep Med. 2017;13(1):19–26. PubMedPubMedCentralCrossRef
Metadata
Title
The association between serum vitamin D and obstructive sleep apnea: an updated meta-analysis
Authors
Xiaoyan Li
Jie He
Jie Yun
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2020
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-020-01554-2

Other articles of this Issue 1/2020

Respiratory Research 1/2020 Go to the issue

Research

Neuromuscular blocking agents for acute respiratory distress syndrome: an updated meta-analysis of randomized controlled trials

Research

Effect of nocturnal EPAP titration to abolish tidal expiratory flow limitation in COPD patients with chronic hypercapnia: a randomized, cross-over pilot study

Review

Mesenchymal stem/stromal cells: the therapeutic effects in animal models of acute pulmonary diseases

Research

Obstructive sleep apnea as a risk factor for primary open angle glaucoma and ocular hypertension in a monocentric pilot study

Research

Factors associated with intraoperative extracorporeal membrane oxygenation support during lung transplantation

Research

Bone marrow mesenchymal stem cells derived miRNA-130b enhances epithelial sodium channel by targeting PTEN
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits