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Causal association between hypothyroidism and obstructive sleep apnea: A bidirectional 2-sample Mendelian

Ning Lu1, Bi Chen2, Pingli Liu2

  • 1Department of General Practice, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

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|October 21, 2024
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Hypothyroidism increases the risk of developing obstructive sleep apnea (OSA), according to a Mendelian randomization study. However, OSA does not appear to cause hypothyroidism, highlighting the need for sleep monitoring in hypothyroid patients.

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Area of Science:

  • Endocrinology
  • Sleep Medicine
  • Genetics

Background:

  • Previous studies on hypothyroidism and obstructive sleep apnea (OSA) have yielded conflicting results.
  • A clear understanding of the causal relationship is crucial for clinical management.

Purpose of the Study:

  • To investigate the causal relationship between hypothyroidism and OSA using a bidirectional 2-sample Mendelian randomization (MR) approach.
  • To clarify whether hypothyroidism predisposes individuals to OSA or vice versa.

Main Methods:

  • Utilized genome-wide association study (GWAS) data for hypothyroidism and OSA.
  • Employed a bidirectional 2-sample MR analysis with multiple estimation methods (IVW, weighted median, MR-Egger, etc.).
  • Conducted sensitivity analyses including heterogeneity, pleiotropy, and leave-one-out tests for result robustness.

Main Results:

  • Forward MR analysis indicated a significant causal association between hypothyroidism and an increased risk of OSA (OR = 1.870).
  • Reverse MR analysis found no evidence of a causal relationship between OSA and the risk of hypothyroidism (P = 0.881).
  • Sensitivity analyses confirmed the robustness of the findings.

Conclusions:

  • Hypothyroidism is a risk factor for developing OSA.
  • OSA does not appear to causally influence the risk of hypothyroidism.
  • Patients with hypothyroidism should prioritize sleep quality monitoring.