TANG Qiaoya, LI Nidong, LI Jing, HUANG Yali, WANG Ying, YANG Rui
Chinese Journal of Reproductive Health. 2025, 36(6): 501-509.
Objective The impact of obstructive sleep apnoea (OSA) on polycystic ovary syndrome (PCOS) has not been extensively investigated. This study aims to investigate the occurrence of OSA in patients with PCOS and to elucidate the effect of OSA on the clinical features of PCOS patients and patients with PCOS alone. Methods PCOS patients who received infertility treatment at Peking University Third Hospital from January 2019 to August 2022 were included. Multiple physiological parameters, including physical indicators, sex hormone levels, inflammation and coagulation indicators, liver and kidney function were measured according to routine clinical measurements. Portable sleep monitoring was performed using Apnealink Plus from ResMed Ltd., Australia, and OSA was classified as mild, moderate, and severe based on respiratory distress index, AHI and nighttime minimum oxygen saturation. Results A total of 687 patients with PCOS were included in this study. Among them, 47% of PCOS patients were complicated with OSA, and 28 patients had severe OSA, accounting for 4%. The body mass index, the proportion of patients with hyperandrogenism (HA) and the proportion of insulin resistance (IR) increased in PCOS & OSA group (P<0.05). In terms of sex hormone, concentration of testosterone and free testosterone index (FAI) in PCOS & OSA group were higher than those in PCOS group alone, while progesterone (P), anti Mullerian hormone (AMH), and sex hormone binding globulin (SHBG) were lower than those in PCOS group alone (P<0.05). In terms of glucose and lipid metabolism indicators,glycated hemoglobin (HbA1c), fasting blood glucose level (Glu0), blood glucose level 30 minutes after oral administration of 75 g glucose (Glu30), blood glucose level 6 minutes after oral administration of 75 g glucose (Glu60), blood glucose level 12 minutes after oral administration of 75 g glucose (Glu120), fasting insulin level (INS0), serum insulin level 30 minutes after oral administration of 75 g glucose (INS30), serum insulin level 60 minutes after oral administration of 75 g glucose (INS60), serum insulin level 120 minutes after oral administration of 75 g glucose (INS120), steady-state model evaluation of insulin resistance index (HOMA-IR), steady-state model insulin secretion index (HOMA - β), beta cell function index (MBCI), low density lipoprotein (LDL) and triglycerides (TG) of PCOS & OSA patients were higher than those of PCOS patients alone. HDL was lower than that of PCOS patients (P<0.05). The US-CRP and prothrombin activity in PCOS & OSA patients were higher than those in PCOS alone (P<0.05). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and cystatin C in PCOS & OSA patients were higher than those in PCOS patients alone (P<0.05). Logistic regression analysis showed that higher high body mass index (BMI) (OR=8.51) and elevated glycosylated hemoglobin (OR=21.76) were associated with high incidence rate of OSA (P<0.05). Conclusion OSA has a high prevalence in Chinese female PCOS patients, and has negative effects on various clinical manifestations of these patients, such as body mass index, sex hormone levels, glucose and lipid metabolism, inflammation, coagulation and biochemical indicators, which worsen with the severity of OSA. High serum HbA1c level was associated with the onset of OSA in Chinese female PCOS patients. In the diagnosis and treatment of PCOS patients in China, attention should be paid to OSA, and corresponding health management and intervention should be provided.
