Thyroxine replacement therapy reverses sleep-disordered breathing in patients with primary hypothyroidism
Thyroxine replacement therapy reverses sleep-disordered breathing in patients with primary hypothyroidism
复制标题
DOI：
10.1016/j.sleep.2005.05.003
复制
发表时间：
2006-01-01
期刊：
影响因子：
4.8
通讯作者：
Chaturvedi, PK
中科院分区：
文献类型：
--
作者：
Jha, A;Sharma, SK;Chaturvedi, PK
背景和目的：坊间报道显示，睡眠呼吸障碍（SDB）在原发性甲状腺功能减退症患者中很常见。本研究旨在确定原发性甲状腺功能减退患者SDB的患病率，并评估甲状腺素替代治疗对SDB的影响。患者和方法：前瞻性研究50例连续新诊断、未经治疗的有症状的原发性甲状腺功能减退患者（年龄34±11岁，男性21岁[42%]）。所有患者在基线时进行体格检查、人体测量、空腹血糖和血脂。所有患者在基线时进行多导睡眠图检查，并在SDB患者进行足够的甲状腺素替代后重复检查。结果：基线时15例（30%）患者存在SDB，定义为呼吸暂停-低通气指数(AHI) >= 5，在甲状腺素替代治疗后评估的12例患者中有10例是可逆的（P = 0.006）。甲状腺素替代疗法与反映上呼吸道受损的检查结果的改善相关，如大舌裂（4例[33%]对1例[8%]，P=0.083）、肌水肿（5例[42%]对1例[8%]，P= 0.046）和面部浮肿（10例[83%]对1例[8%]，P= 0.003）。结论：可逆性SDB在原发性甲状腺功能减退患者中较为常见。甲状腺功能减退导致的上呼吸道解剖结构改变可能是这些患者SDB发展的原因之一。(c) 2005 Elsevier B.V.版权所有
Background and purpose: Anecdotal reports suggest that sleep-disordered breathing (SDB) is common among patients with primary hypothyroidism. This study was undertaken to determine the prevalence of SDB and to evaluate the effect of thyroxine replacement therapy on SDB in patients with primary hypothyroidism.Patients and methods: Fifty consecutive newly diagnosed, untreated symptomatic patients with primary hypothyroidism (age: 34 +/- 11 years; males: 21 [42%]) were prospectively studied. Physical examination, anthropometry, fasting blood glucose and serum lipids were performed in all patients at baseline. Polysomnography was done at baseline in all patients and was repeated after adequate thyroxine replacement in those who had SDB.Results: SDB defined as apnea-hypopnea index (AHI) >= 5 was present in 15 patients (30%) at baseline and was reversible in 10 of the 12 patients evaluated following thyroxine replacement therapy (P = 0.006). Thyroxine replacement therapy was associated with improvement in findings that reflect a compromised upper airway, such as macroglossia (4 [33%] vs. 1 [8%]; P=0.083), myoedema (5 [42%] vs. 1 [8%]; P = 0.046) and facial puffiness (10 [83%] vs. 1 [8%]; P = 0.003).Conclusions: Reversible SDB is common among patients with primary hypothyroidism. Changes in upper airway anatomy resulting from hypothyroidism probably contribute to the development of SDB in these patients. (c) 2005 Elsevier B.V. All rights reserved.