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The worse the sleep apnea, the lower the vitamin D levels – meta-analysis Dec 2017

Vitamin D and obstructive sleep apnea: a systematic review and meta-analysis

Sleep Medicine, online 14 December 2017, https://doi.org/10.1016/j.sleep.2017.10.016
Cindy L. Neighborsa, Michael W. Nollerb, Sungjin A. Songa, Soroush Zaghic, John Neighborsb, David Feldmand, Clete A. Kushidae, Macario Camachoa,

Level Vit DReduction
None28 ng -
Mild27 ng3 %
Moderate 25 ng10%
Severe22 ng17 %

See also VitaminDWiki

See also web

Self-evaluation questions for the reader
1. Regarding the role of vitamin D insufficiency in OSAS patients, which of the following is/are correct?

  • a) Serum 25(OH)D is considered the best indicator of vitamin D status in OSAS patients.
  • b) Vitamin D deficiency and OSAS present common risk factors and comorbidities, such as older age and obesity.
  • c) There are a lack of vitamin D receptors in brain areas involved in sleep regulation.
  • d) There are no common pathogenetic features between the two conditions.

2. Which of the following is/are correct regarding the mechanism by which vitamin D insufficiency enhances the development of OSAS?

  • a) A decrease in pharyngeal dilator muscle strength, thus reducing pharyngeal patency and predisposing to apnoeic events during sleep.
  • b) An immune system dysregulation, associated with increased incidence of upper respiratory tract infections and tonsillar hypertrophy.
  • c) Promoting the secretion of pro-inflammatory cytokines.

3. Regarding the effect of obesity on serum concentrations of vitamin D, which of the following is/are correct?

  • a) In healthy individuals, serum vitamin D levels are independent from obesity.
  • b) Subcutaneous adipose tissue presents high expression of the enzymes responsible for vitamin D activation.
  • c) Fat tissue acts as a storage site for vitamin D and it is released when serum levels decrease.
  • d) Obesity may mediate the influence of CPAP therapy on vitamin D levels.

4. Regarding serum vitamin D levels in OSAS, which of the following is/are correct?

  • a) Available evidence indicates increased levels after short-term CPAP therapy.
  • b) Serum VDBP levels remain unchanged in response to chronic hypoxia.
  • c) The association between vitamin D insufficiency and hypoxia may be mediated by mechanisms involving HIF-1α and VEGF.
  • d) A positive correlation between serum vitamin D levels and inflammatory factors, such as IL-17,

PDF is available free at Sci-Hub   10.1016/j.sleep.2017.10.016

Several studies have reported an association between 25-hydroxyvitamin D (25(OH)D) levels and obstructive sleep apnea (OSA) patients. The objective of the current study was to perform a systematic review and meta-analysis of these studies and report the findings.

Authors searched for studies (through January 1, 2017) reporting 25(OH)D serum levels in OSA patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed.

Fourteen studies with 4937 subjects met inclusion criteria. There were 1513 controls and 3424 OSA patients. The 25(OH)D serum levels for controls and mild OSA patients were 28.16±9.39 ng/mL (95% CI 27.64, 28.68) and 27.41±9.42 ng/mL (95% CI 26.87, 27.95), respectively. The 25(OH)D serum levels for controls and moderate OSA patients were 28.21±9.38 ng/mL (95% CI 27.70, 28.72) and 25.48±10.34 ng/mL (95% CI 24.68, 26.28), respectively. The 25(OH)D serum levels for controls and severe OSA patients were 28.32±9.65 ng/mL (95% CI 27.80, 28.84) and 21.88±10.24 ng/mL (95% CI 21.08, 22.68), respectively. Using random effects modeling, the 25(OH)D serum levels were decreased for patients with OSA when compared to control groups (mean differences were

  • –2.7% for mild OSA,
  • –10.1% for moderate OSA and
  • –17.4% for severe OSA).

There was a relative insufficiency in serum 25(OH)D levels among OSA patients compared to control patients, which was incrementally exacerbated with increasing severity of sleep apnea. It was unclear whether a low 25(OH)D was a risk factor for OSA or if OSA was a risk factor for 25(OH)D. It was also possible that the association between 25(OH)D and OSA was due to body mass index (BMI).

Created by admin. Last Modification: Tuesday December 31, 2019 17:39:10 GMT-0000 by admin. (Version 9)

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