1381 LOW SERUM TESTOSTERONE IS ASSOCIATED WITH OBSTRUCTIVE SLEEP APNEA IN MIDDLE AGED MEN

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation II1 Apr 20121381 LOW SERUM TESTOSTERONE IS ASSOCIATED WITH OBSTRUCTIVE SLEEP APNEA IN MIDDLE AGED MEN Mary Ann McLaughlin, Boback Berookhim, Farah Noorani, Cynara Maceda, Ronald Tamler, Rupa Iyengar, Simonette Sawit, Narayan Escolin, Jacqueline O'Boyle, Samuel Kurtis, Jacqueline Moline, and Natan Bar-Chama Mary Ann McLaughlinMary Ann McLaughlin New York, NY More articles by this author , Boback BerookhimBoback Berookhim New York, NY More articles by this author , Farah NooraniFarah Noorani New York, NY More articles by this author , Cynara MacedaCynara Maceda New York, NY More articles by this author , Ronald TamlerRonald Tamler New York, NY More articles by this author , Rupa IyengarRupa Iyengar New York, NY More articles by this author , Simonette SawitSimonette Sawit New York, NY More articles by this author , Narayan EscolinNarayan Escolin New York, NY More articles by this author , Jacqueline O'BoyleJacqueline O'Boyle New York, NY More articles by this author , Samuel KurtisSamuel Kurtis New York, NY More articles by this author , Jacqueline MolineJacqueline Moline New York, NY More articles by this author , and Natan Bar-ChamaNatan Bar-Chama New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1808AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Obstructive sleep apnea (OSA) is implicated in the initiation and progression of cardiovascular disease (CVD). Recent studies assert male hypogonadism as a strong predictor for cardiovascular events, with small studies pointing to a specific correlation between hypogonadism and OSA in elderly men. Mediators of the association between both OSA and hypogonadism with CVD include endothelial dysfunction, inflammation, and oxidative stress, among others. The Berlin Questionnaire is the most widely used questionnaire for OSA, with published sensitivity up to 86% and specificity of 87%. We aim to characterize the relationship between patients at high risk for OSA and hypogonadism in a large population of middle-aged men. METHODS We evaluated 2,121 male law enforcement personnel from the World Trade Center Medical Monitoring and Treatment Program. Hypogonadism was defined as total testosterone (TT) level < 300 ng/dL. Patients with a positive score on the Berlin Questionnaire were identified as OSA screen positive (OSA+), indicating high risk for OSA. A chi-squared test and independent t-test were used to assess differences between hypogonadism and OSA+. We performed multivariate binary logistic regression to adjust for body mass index (BMI), and Framingham Risk Score (FRS), a validated measure of 10 year cardiovascular risk. RESULTS Mean age was 47 years, with a mean BMI of 30.4 kg/m2 among the patient population. 810 patients (38.2%) had hypogonadism and 911 patients (43.0%) were OSA+. Mean FRS were significantly higher among those patients who were OSA+ as opposed to normal counterparts (7.03 versus 6.14 respectively, p<0.0001). Men with hypogonadism were more than twice as likely to be OSA+ than eugonadal counterparts (OR 2.04, 95% CI 1.7–2.43, p<0.0001). Adjusting for BMI and FRS, hypogonadal men were 49% more likely to be OSA+ (OR 1.49, 95% CI 1.23-1.80, p<0.0001). CONCLUSIONS We observed a significant association between low serum testosterone and those at high risk for OSA as defined by the Berlin Questionnaire, after controlling for confounding variables. Clinicians should be encouraged to screen for OSA in hypogonadal men as part of overall risk assessment. Further research is necessary to describe the underlying pathophysiology connecting the two conditions. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e561 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mary Ann McLaughlin New York, NY More articles by this author Boback Berookhim New York, NY More articles by this author Farah Noorani New York, NY More articles by this author Cynara Maceda New York, NY More articles by this author Ronald Tamler New York, NY More articles by this author Rupa Iyengar New York, NY More articles by this author Simonette Sawit New York, NY More articles by this author Narayan Escolin New York, NY More articles by this author Jacqueline O'Boyle New York, NY More articles by this author Samuel Kurtis New York, NY More articles by this author Jacqueline Moline New York, NY More articles by this author Natan Bar-Chama New York, NY More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...