Evidence mapPaperPMID 41508106Full record

ArticleBiology of sex differences2026

Sex-specific associations between obstructive sleep apnea and thyroid hormone sensitivity in euthyroid adults.

Beini Zhou, Yixuan Wang, Yuhan Wang, Jingyi Zhang, Qingfeng Zhang, Ke Hu

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Article in Biology of sex differences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Beini Zhou *Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, 238 Jiefang Street, 430060, Wuhan, China.
Yixuan Wang *Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, 238 Jiefang Street, 430060, Wuhan, China.
Yuhan WangDepartment of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, 238 Jiefang Street, 430060, Wuhan, China.
Jingyi ZhangDepartment of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, 238 Jiefang Street, 430060, Wuhan, China.
Qingfeng ZhangDepartment of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, 238 Jiefang Street, 430060, Wuhan, China.
Ke HuDepartment of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, 238 Jiefang Street, 430060, Wuhan, China. huke-rmhospital@163.com.ORCID 0000-0001-9862-7239

Funding

National Natural Science Foundation of China 82270101
6 · The paper itself

Abstract

backgroundThe relationship between obstructive sleep apnea (OSA) and thyroid hormone sensitivity remains unclear. Thyroid hormone sensitivity indices may reveal subclinical hypothalamic-pituitary-thyroid (HPT) axis dysregulation beyond conventional hormone levels.

methodsWe analyzed 718 euthyroid adults who underwent overnight sleep monitoring, using thyroid‑stimulating hormone index (TSHI), thyroid feedback quantile-based index (TFQI), parametric thyroid feedback quantile-based index (PTFQI), thyrotroph T4 resistance index (TT4RI), thyrotroph T3 resistance index (TT3RI) and the ratio of free triiodothyronine to free thyroxine (FT3/FT4 ratio) to assess central and peripheral thyroid hormone sensitivity. Analysis of covariance assessed differences across OSA severity after adjusting for age and BMI. Multivariable linear regression examined associations between OSA severity and thyroid hormone sensitivity indices in sex-stratified models. Correlations between OSA-related parameters and thyroid hormones sensitivity indices were further explored using quadratic prediction plots.

resultsAmong females, OSA patients showed higher FT4 and significantly increased TFQI, PTFQI, TSHI, and TT4RI, but lower FT3/FT4 ratio compared with non-OSA. TFQI (P for trend = 0.0395) and TT4RI (P for trend = 0.0293) were positively correlated with increasing OSA severity. OSA was independently associated with elevated TFQI (β = 0.26, 95% CI 0.010-0.42, P = 0.001), PTFQI (β = 0.20, 95% CI 0.05-0.35, P = 0.011), TSHI (β = 0.24, 95% CI 0.03-0.44, P = 0.025), and TT4RI (β = 6.82, 95% CI 0.59-13.05, P = 0.033). apnea-hypopnea index (AHI), oxygen desaturation index (ODI) were significantly correlated with TT4RI (P = 0.034, 0.021, respectively). No significant associations were observed in males.

conclusionsOSA is associated with impaired central and peripheral thyroid hormone sensitivity in euthyroid females, but not in males.

Indexed as

Sex CharacteristicsSleep Apnea, ObstructiveThyroid GlandThyroid HormonesAdultFemaleHumansMaleMiddle AgedTriiodothyronineThyroid HormonesTriiodothyronineIntermittent hypoxiaObstructive sleep apneaThyroid hormone sensitivity.

Identifiers

PMID41508106
PMCPMC12870024

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.