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Published in: Sleep and Breathing 1/2017

01-03-2017 | Sleep Breathing Physiology and Disorders • Original Article

The effect of obstructive sleep apnea syndrome and hypothyroidism to intima-media thickness of carotid artery

Authors: Fulsen Bozkus, Nursel Dikmen, Gülay Güngör, Anıl Samur

Published in: Sleep and Breathing | Issue 1/2017

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Abstract

Aim

Obstructive sleep apnea syndrome (OSAS) is a common disorder and in subjects with OSAS the prevalence of hypothyroidism is approximately 1.2–11 %. The episodes of hypoxia/reoxygenation associated with the respiratory disturbances observed in subjects with OSAS increases the risk of cardiovascular diseases. Hypothyroidism; primary or subclinical, has several effects on cardiovascular system. In our study, we investigated carotid artery intima-media thickness (IMT) which is an early sign of atherosclerosis, in OSAS subjects with hypothyroidism.

Materials and method

Subjects who admitted to Kahramanmaras Necip Fazıl City State Hospital Chest Diseases out-patient clinic between May 2014 and January 2016 for snoring and had polysomnographic evaluation at the sleep laboratory were included in this study. Each subject was evaluated for serum thyroid function tests and carotid artery IMT was measured by a Doppler ultrasound.

Results

Mean carotid artery IMT values in the isolated OSAS, OSAS plus hypothyroidism, and control groups were 0.67 ± 0.12, 0.8 ± 0.12, and 0.54 ± 0.08 mm, respectively; difference between groups was statistically significant (p < .05). A poXsitive correlation was found between thyroid stimulating hormone levels and IMT (r = 0.426, p = .002), while free T3 levels and IMT were negatively correlated (r = −0.463, p = .001). IMT and apnea-hypopnea index were also positively correlated (r = 0.403, p = .003).

Conclusion

We suggest, physicians should be alert for hypothyroidism comorbidity in OSAS, and suspected subjects with OSAS should be screened for hypothyroidism considering the potential cardiovascular complications.
Literature
1.
go back to reference Attal P, Chanson P (2010) Endocrine aspects of obstructive sleep apnea. J Clin Endocrinol Metab 95(2):483–495CrossRefPubMed Attal P, Chanson P (2010) Endocrine aspects of obstructive sleep apnea. J Clin Endocrinol Metab 95(2):483–495CrossRefPubMed
2.
go back to reference Mitu F, Cojocaru E, Tamba B, Leon MM (2012) Prevalence of cardiovascular diseases in patients with hypothyroidism. Rev Med Chir Soc Med Nat 116(2):413–418 Mitu F, Cojocaru E, Tamba B, Leon MM (2012) Prevalence of cardiovascular diseases in patients with hypothyroidism. Rev Med Chir Soc Med Nat 116(2):413–418
3.
go back to reference Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC (2000) Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam study. Ann Intern Med 132(4):270–278CrossRefPubMed Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC (2000) Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam study. Ann Intern Med 132(4):270–278CrossRefPubMed
4.
go back to reference Salepci B, Fidan A, Ketenci SC, Parmaksiz ET, Comert SS, Kiral N, et al. (2015) The effect of obstructive sleep apnea syndrome and snoring severity to intima-media thickening of carotid artery. Sleep Breath 19(1):239–246CrossRefPubMed Salepci B, Fidan A, Ketenci SC, Parmaksiz ET, Comert SS, Kiral N, et al. (2015) The effect of obstructive sleep apnea syndrome and snoring severity to intima-media thickening of carotid artery. Sleep Breath 19(1):239–246CrossRefPubMed
6.
go back to reference Ozdemir C, Conkbayır I, Kuru A, Fırat H, Sökücü SN, Dalar L, et al. (2013) Correlation between the intima-media thickness and Framingham risk score in patients with sleep apnea syndrome. J Thorac Dis 5(6):751–757PubMedPubMedCentral Ozdemir C, Conkbayır I, Kuru A, Fırat H, Sökücü SN, Dalar L, et al. (2013) Correlation between the intima-media thickness and Framingham risk score in patients with sleep apnea syndrome. J Thorac Dis 5(6):751–757PubMedPubMedCentral
7.
go back to reference Ciccone MM, Scicchitano P, Mitacchione G, Zito A, Gesualdo M, Caputo P, et al. (2012) Is there a correlation between OSAS duration/severity and carotid intima-media thickness? Respir Med 106(5):740–746CrossRefPubMed Ciccone MM, Scicchitano P, Mitacchione G, Zito A, Gesualdo M, Caputo P, et al. (2012) Is there a correlation between OSAS duration/severity and carotid intima-media thickness? Respir Med 106(5):740–746CrossRefPubMed
8.
go back to reference Hui DS, Shang Q, Ko FW, Ng SS, Szeto CC, Ngai J, et al. (2012) A prospective cohort study of the long-term effects of CPAP on carotid artery intima-media thickness in obstructive sleep apnea syndrome. Respir Res 16:13–22 Hui DS, Shang Q, Ko FW, Ng SS, Szeto CC, Ngai J, et al. (2012) A prospective cohort study of the long-term effects of CPAP on carotid artery intima-media thickness in obstructive sleep apnea syndrome. Respir Res 16:13–22
9.
go back to reference American Academy of Sleep Medicine (2014) ICSD-3:the international classification of sleep disorders. Diagnostic and coding manual. AASM, Westchester, Illinois American Academy of Sleep Medicine (2014) ICSD-3:the international classification of sleep disorders. Diagnostic and coding manual. AASM, Westchester, Illinois
10.
go back to reference Devdhar M, Ousman YH, Burman KD (2007) Hypothyroidism. Endocrinol Metab Clin N Am 36(3):595–615CrossRef Devdhar M, Ousman YH, Burman KD (2007) Hypothyroidism. Endocrinol Metab Clin N Am 36(3):595–615CrossRef
11.
go back to reference Demirdogen E, Karadag M (2007) Laboratory evaluation of obstructive sleep apnea syndrome: other laboratory tests. Turkiye Klinikleri J Surg Med Sci 23:71–73 Demirdogen E, Karadag M (2007) Laboratory evaluation of obstructive sleep apnea syndrome: other laboratory tests. Turkiye Klinikleri J Surg Med Sci 23:71–73
12.
go back to reference Morqenter TI, Kapen S, Lee Cihong T, Alessi C, Boehlecke B, Brown T (2006) Pratice parameter for the medical therapy of obstructive sleep apnea. Sleep 29(8):1131–1135 Morqenter TI, Kapen S, Lee Cihong T, Alessi C, Boehlecke B, Brown T (2006) Pratice parameter for the medical therapy of obstructive sleep apnea. Sleep 29(8):1131–1135
13.
go back to reference Winkelman JW, Goldman H, Piscatelli N, Lukas S, Dorsey CM, Cunningham S (1996) Are thyroid function tests necessary in patients with suspected sleep apnea? Sleep 19:790–793PubMed Winkelman JW, Goldman H, Piscatelli N, Lukas S, Dorsey CM, Cunningham S (1996) Are thyroid function tests necessary in patients with suspected sleep apnea? Sleep 19:790–793PubMed
14.
go back to reference Lin CC, Tsan KW, Chen PJ (1992) The relationship between sleep apnea syndrome and hypothyroidism. Chest 102(6):1663–1667CrossRefPubMed Lin CC, Tsan KW, Chen PJ (1992) The relationship between sleep apnea syndrome and hypothyroidism. Chest 102(6):1663–1667CrossRefPubMed
15.
go back to reference Popovici I, Khawaja I (1997) Efficacy of thyroid function tests in patients suspected of having obstructive sleep apnea. Chest 112:149CrossRef Popovici I, Khawaja I (1997) Efficacy of thyroid function tests in patients suspected of having obstructive sleep apnea. Chest 112:149CrossRef
16.
go back to reference Mete T, Yalcin Y, Berker D, Ciftci B, Firat SG, Topaloglu O, et al. (2013) Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine 44:723–728CrossRefPubMed Mete T, Yalcin Y, Berker D, Ciftci B, Firat SG, Topaloglu O, et al. (2013) Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine 44:723–728CrossRefPubMed
17.
go back to reference Cappola AR, Ladenson PW (2003) Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab 88(6):2438–2344CrossRefPubMed Cappola AR, Ladenson PW (2003) Hypothyroidism and atherosclerosis. J Clin Endocrinol Metab 88(6):2438–2344CrossRefPubMed
18.
go back to reference Polak JF, Pencina MJ, Pencina KM, O’Donnell CJ, Wolf PA, D’Agostino RB Sr (2011) Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med 365(3):213–221CrossRefPubMedPubMedCentral Polak JF, Pencina MJ, Pencina KM, O’Donnell CJ, Wolf PA, D’Agostino RB Sr (2011) Carotid-wall intima-media thickness and cardiovascular events. N Engl J Med 365(3):213–221CrossRefPubMedPubMedCentral
19.
go back to reference Kablak-Ziembicka A, Tracz W, Przewlocki T, Pieniazek P, Sokolowski A, Konieczynska M (2004) Association of increased carotid intima-media thickness with the extent of coronary artery disease. Heart 90(11):1286–1290CrossRefPubMedPubMedCentral Kablak-Ziembicka A, Tracz W, Przewlocki T, Pieniazek P, Sokolowski A, Konieczynska M (2004) Association of increased carotid intima-media thickness with the extent of coronary artery disease. Heart 90(11):1286–1290CrossRefPubMedPubMedCentral
20.
go back to reference Dursunoglu N, Dursunoglu D (2014) Obstructive sleep apnea syndrome and cardiovascular complications. Güncel Göğüs Hastalıkları Serisi 2(2):159–169CrossRef Dursunoglu N, Dursunoglu D (2014) Obstructive sleep apnea syndrome and cardiovascular complications. Güncel Göğüs Hastalıkları Serisi 2(2):159–169CrossRef
21.
go back to reference Baguet JP, Hammer L, Levy P, Pierre H, Launois S, Mallion JM, Pepin JL (2005) The severity of oxygen desaturation is predictive of carotid wall thickening and plaque occurrence. Chest 128(5):3407–3412CrossRefPubMed Baguet JP, Hammer L, Levy P, Pierre H, Launois S, Mallion JM, Pepin JL (2005) The severity of oxygen desaturation is predictive of carotid wall thickening and plaque occurrence. Chest 128(5):3407–3412CrossRefPubMed
22.
go back to reference Silvestrini M, Rizzato B, Placidi F, Baruffaldi R, Bianconi A, Diomedi M (2002) Carotid artery wall thickness in patients with obstructive sleep apnea syndrome. Stroke 33(7):1782–1785CrossRefPubMed Silvestrini M, Rizzato B, Placidi F, Baruffaldi R, Bianconi A, Diomedi M (2002) Carotid artery wall thickness in patients with obstructive sleep apnea syndrome. Stroke 33(7):1782–1785CrossRefPubMed
23.
go back to reference Güney E, Arslan M, Şalk I, Dogan OT, Akkurt I (2010) Carotid artery on the effect of obstructive sleep apnea syndrome. Cumhuriyet Tıp Derg 32:288–294 Güney E, Arslan M, Şalk I, Dogan OT, Akkurt I (2010) Carotid artery on the effect of obstructive sleep apnea syndrome. Cumhuriyet Tıp Derg 32:288–294
24.
go back to reference Gorzewska A, Specjalski K, Drozdowski J (2013) Intima-media thickness in patients with obstructive sleep apnea without comorbidities. Lung 191(4):397–404CrossRefPubMedPubMedCentral Gorzewska A, Specjalski K, Drozdowski J (2013) Intima-media thickness in patients with obstructive sleep apnea without comorbidities. Lung 191(4):397–404CrossRefPubMedPubMedCentral
25.
go back to reference Nagasaki T, Inaba M, Henmi Y, Kumeda Y, Ueda M, Tahara H, et al. (2003) Decrease in carotid intima-media thickness in hypothyroid patients after normalization of thyroid function. Clin Endocrinol 59(5):607–612CrossRef Nagasaki T, Inaba M, Henmi Y, Kumeda Y, Ueda M, Tahara H, et al. (2003) Decrease in carotid intima-media thickness in hypothyroid patients after normalization of thyroid function. Clin Endocrinol 59(5):607–612CrossRef
26.
go back to reference Asik M, Sahin S, Ozkul F, Anaforoglu I, Ayhan S, Karagol S, et al. (2013) Evaluation of epicardial fat tissue thickness in patients with Hashimoto thyroiditis. Clin Endocrinol 79(4):571–576. doi:10.1111/cen.12176 CrossRef Asik M, Sahin S, Ozkul F, Anaforoglu I, Ayhan S, Karagol S, et al. (2013) Evaluation of epicardial fat tissue thickness in patients with Hashimoto thyroiditis. Clin Endocrinol 79(4):571–576. doi:10.​1111/​cen.​12176 CrossRef
27.
go back to reference Fox N, Ayas N, Park JE, Fleetham J, Frank Ryan C, Lear SA, et al. (2014) Carotid intima media thickness in patients with obstructive sleep apnea: comparison with a community-based cohort. Lung 192(2):297–303CrossRefPubMed Fox N, Ayas N, Park JE, Fleetham J, Frank Ryan C, Lear SA, et al. (2014) Carotid intima media thickness in patients with obstructive sleep apnea: comparison with a community-based cohort. Lung 192(2):297–303CrossRefPubMed
28.
go back to reference Apaydın M, Ayik SO, Akhan G, Peker S, Uluc E (2013) Carotid intima-media thickness increase in patients with habitual simple snoring and obstructive sleep apnea syndrome is associated with metabolic syndrome. J Clin Ultrasound 41(5):290–296CrossRefPubMed Apaydın M, Ayik SO, Akhan G, Peker S, Uluc E (2013) Carotid intima-media thickness increase in patients with habitual simple snoring and obstructive sleep apnea syndrome is associated with metabolic syndrome. J Clin Ultrasound 41(5):290–296CrossRefPubMed
29.
go back to reference Ozcan KM, Selcuk A, Ozcan I, Ozdas T, Ozdogan F, Acar M, et al. (2014) Incidence of hypothyroidism and its correlation with polysomnography findings in obstructive sleep apnea. Eur Arch Otorhinolaryngol 271(11):2937–2941CrossRefPubMed Ozcan KM, Selcuk A, Ozcan I, Ozdas T, Ozdogan F, Acar M, et al. (2014) Incidence of hypothyroidism and its correlation with polysomnography findings in obstructive sleep apnea. Eur Arch Otorhinolaryngol 271(11):2937–2941CrossRefPubMed
30.
go back to reference Ozısık NC, Yurteri G, Tuzun B, Ozturk O, Oruc O (2008) Should patients with obstructive sleep apnea syndrome be screened for hypothyroidisim? SDU Tıp Fak Derg 15(4):18–22 Ozısık NC, Yurteri G, Tuzun B, Ozturk O, Oruc O (2008) Should patients with obstructive sleep apnea syndrome be screened for hypothyroidisim? SDU Tıp Fak Derg 15(4):18–22
Metadata
Title
The effect of obstructive sleep apnea syndrome and hypothyroidism to intima-media thickness of carotid artery
Authors
Fulsen Bozkus
Nursel Dikmen
Gülay Güngör
Anıl Samur
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
Sleep and Breathing / Issue 1/2017
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-016-1384-2

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