Thyroid Stimulating Hormone Is Increased in Hypertensive Patients with Obstructive Sleep Apnea

Abstract

Purpose. To evaluate alteration in serum TSH in hypertensives with OSA and its relation with cardiometabolic risk factors. Methods. 517 hypertensives were cross-sectionally studied. OSA was determined by polysomnography and thyroid function by standard methods. Results. OSA was diagnosed in 373 hypertensives (72.15%). Prevalence of subclinical hypothyroidism was significantly higher in OSA hypertensives than in non-OSA ones (15.0% versus 6.9%, P=0.014). Serum LnTSH in hypertensives with severe OSA was significantly higher (0.99±0.81 versus 0.74±0.77 μIU/mL, P<0.05) than in those without OSA. AHI, LSaO2, ODI3, and ODI4 were independently associated with serum TSH for those aged 30–65 years. Dividing subjects into four groups as TSH < 1.0 μIU/mL, 1.0 ≤ THS ≤ 1.9 μIU/mL, 1.91 ≤ TSH < 4.5 μIU/mL, and TSH ≥ 4.5 μIU/mL, only 26.3% of OSA subjects exhibited TSH between 1.0 and 1.9 μIU/mL, significantly less than non-OSA subjects (26.3% versus 38.2%, P=0.01). DBP and serum LDL-c elevated with TSH increasing and were only significantly higher in TSH ≥ 4.5 μIU/mL group than in 1.0 ≤ TSH ≤ 1.9 μIU/mL group (96.32±14.19 versus 92.31±12.86 mmHg; P=0.040; 0.99±0.60 versus 0.87±0.34 mmol/L, P=0.023). Conclusion. OSA might be a risk factor for increased TSH even within reference range in hypertensive population.