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Updated: May 14, 2025

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Obstructive sleep apnea and osteoporosis: A bidirectional two-sample mendelian randomization analysis.

Yiting Tu1, Jiansen Miao1, Qihang Wu1

  • 1Department of Orthopedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, China.

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|April 11, 2025
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Summary

This study found a causal link between obstructive sleep apnea (OSA) and femoral neck bone mineral density (FA-BMD), suggesting OSA may impact bone health. Further research is needed to understand this connection in osteoporosis.

Keywords:
Bone mineral densityCausalityFractureMendelian randomizationObstructive sleep apneaOsteoporosis

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Area of Science:

  • Genetics and Epidemiology
  • Bone Metabolism Research
  • Sleep Medicine

Background:

  • Previous studies on obstructive sleep apnea (OSA) and osteoporosis (OP) yielded inconsistent results due to biases.
  • This study aimed to establish a causal link between OSA and OP using Mendelian randomization.

Purpose of the Study:

  • To investigate the causal association between obstructive sleep apnea (OSA) and osteoporosis (OP).
  • To explore the potential impact of OSA on bone mineral density (BMD) and fracture risk.

Main Methods:

  • Utilized bidirectional two-sample Mendelian randomization analysis.
  • Employed summary-level data for OSA from FinnGen and for BMDs/fractures from UKBB and GEFOS.
  • Applied the inverse variance weighted (IVW) method as the primary analysis, with sensitivity analyses for robustness.

Main Results:

  • A significant causal association was found between OSA and femoral neck bone mineral density (FA-BMD) (BETA = 0.404, p = 5.28 × 10-5).
  • No significant causal relationships were observed between OSA and other BMD measures (eBMD, FN-BMD, LS-BMD) or fracture risk.
  • Reverse analysis indicated no definitive causal effect of OP on OSA.

Conclusions:

  • This research provides strong evidence for a causal link between obstructive sleep apnea (OSA) and femoral neck bone mineral density (FA-BMD).
  • The findings highlight a potential role for OSA in influencing bone metabolism, specifically at the femoral neck.