FRACTURE RISK AND OBSTRUCTIVE SLEEP APNOEA

Abstract

Obstructive Sleep Apnoea (OSA) with hypoxemia, oxidative stress, low-grade inflammation and multiple hormonal metabolic changes affect the bone metabolism. This leads to an increased fracture risk in patients with OSA. Purpose: The aim of the study was to explore the connection between fracture risk and newly-diagnosed OSA. Materials/methods: 130 patients with newly diagnosed OSA and 67 controls without OSA were included in the study. Anthropometric, laboratory, instrumental and study tests and fracture risk assessment under the FRAX program were performed. Results: There isn’t a statistical difference in the age and gender in the OSA group compared to the controls (p>0.05). A statistically significant difference between the OSA group and the control group was found with regard to the body mass index (BMI), visceral fat mass ratio (VFR), neck circumference, Epworth sleepiness scale (ESS), Vitamin D levels, beta-crosslaps and osteocalcin (р<0.0001 for all). Reduction of bone mineral density (BMD) was found in patients with OSA. On average, three risk factors for fracture were found in patients with OSA compared to an absence or only one risk factor in the control group (р<0.0001). Conclusion: Patients with OSA are at an increased fracture risk due to disturbed bone metabolism. They have lower Vitamin D levels, reduction of BMD and 3 risk factors for high FR. This requiresan assessment of fracture risk and its eventual reduction in patients with OSA.

Keywords

• squamous cell carcinoma of the skin
• histopathology
• recurrence
• metastasis
• mortality