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Cited by 168Obstructive Sleep Apnea ResearchNeuroscience of respiration and sleepThyroid Disorders and Treatments

Pituitary reactivity, androgens and catecholamines in obstructive sleep apnoea. Effects of continuous positive airway pressure treatment (CPAP)

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Bratel, T., Wennlund, A., Carlström, K.·1999·Respiratory Medicine
DOI 10.1016/s0954-6111(99)90068-9
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Abstract

We studied the effects of chronic nocturnal hypoxaemia due to obstructive sleep apnoea syndrome (OSAS) on the hypothalamic-pituitary-thyroid and hypothalamic-pituitary-testicular axes and on catecholamine and cortisol secretion. We investigated whether hormones other than catecholamines may serve as markers for chronic hypoxic stress and the possible effects of nasal continuous positive airway pressure (nCPAP) treatment on endocrine status. Nocturnal oximetry was performed in 16 male patients with OSAS diagnosed by polysomnography, immediately before nCPAP treatment and in 11 of the patients the oximetry was repeated after 7 months of nCPAP therapy. Plasma and urinary catecholamines, luteinizing hormone (LH) testosterone, cortisol, thyroid stimulating hormone (TSH), prolactin (PRL), and the response of TSH and PRL to a thyroid releasing hormone (TRH) challenge test were measured immediately before and after 7 months of nCPAP treatment. Subnormal LH and TSH and elevated serum cortisol as well as increased nocturnal urinary norepinephrine levels were found in patients prior to treatment; otherwise endocrine values were normal. There was a significant correlation between low pretreatment nocturnal arterial oxygen saturation and high plasma and urinary norepinephrine levels. The nCPAP treatment caused significant reduction in serum prolactin and TSH, and significant reduction in plasma epinephrine and urinary norepinephrine. The reduction in serum TSH and urinary norepinephrine was most pronounced in the subjects with the worst pretreatment nocturnal hypoxaemia. No other significant changes were found in basal hormone levels. The response to TRH challenge was normal before and after treatment and was not influenced by CPAP therapy. OSAS is associated with elevated catecholamine and cortisol and decreased TSH and LH levels but a normal response to TRH challenge and a normal androgen status. Apart from catecholamines, none of the hormones studied is likely to serve as a specific marker for chronic hypoxic stress.

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  • Some derangement in TSH secretion in obesity with or without OSAS has been demonstrated.

    “In fact, some derangement in TSH secretion in obesity with or without OSAS has been demonstrated [2,4].”

    From Sleep apnea syndrome and hypothyroidism (2013) · cites this paper as [2]

    The Discussion (page not available in our copy) reports lower basal TSH in patients with OSAS than in controls, supporting a TSH disturbance in OSAS. It does not establish a TSH secretion disturbance in obesity without OSAS, or attribute the finding to obesity itself. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Bratel et al. reported a more pronounced reduction of serum TSH in OSAS patients with the most severe nocturnal hypoxemia, with a normal TSH response to TRH before and after nCPAP treatment.

    “Bratel et al. [2] have reported a more pronounced reduction of serum TSH in OSAS patients with the most severe nocturnal hypoxemia, with a normal TSH response to TRH before and after nCPAP treatment.”

    From Sleep apnea syndrome and hypothyroidism (2013) · cites this paper as [2]

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Authors
Bratel, T., Wennlund, A., & Carlström, K.
Affiliations
Karolinska Institutet (SE)
Venue
Respiratory Medicine
Publisher
Elsevier BV
Published
1999-01
Volume
93
Issue
1
Pages
1-7
ISSN
0954-6111 (ISSN-L)
DOI
10.1016/s0954-6111(99)90068-9
OpenAlex
W2057240609
Cited by
168
References
5
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 9 · 2020: 5 · 2019: 2 · 2018: 9 · 2017: 3 · 2016: 6 · 2015: 12 · 2014: 11 · 2013: 6 · 2012: 4
FWCI
1.70
Type
journal article
Language
en
Open access
Licence
Locations
  • Respiratory Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
Karolinska Institutet
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Keywords
obstructive sleep apnea, continuous positive airway pressure, nocturnal hypoxemia, catecholamines, norepinephrine, cortisol, thyroid-stimulating hormone, luteinizing hormone, prolactin, androgens, hypothalamic-pituitary-thyroid axis, hypothalamic-pituitary-testicular axis, epinephrine
MeSH terms
Adult, Aged, Humans, Hydrocortisone, Luteinizing Hormone, Male, Middle Aged, Norepinephrine, Oximetry, Pituitary Gland, Positive-Pressure Respiration, Sleep Apnea Syndromes, Thyrotropin, Thyrotropin-Releasing Hormone, Biomarkers, Statistics, Nonparametric

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