Association between obstructive sleep apnea and male serum testosterone: A systematic review and meta-analysis.

Abstract

BACKGROUND\nCurrently, there is no consensus on the effect of obstructive sleep apnea (OSA) on male serum testosterone levels. This systematic review and meta-analysis aimed to determine the association between OSA and male serum testosterone level.\n\n\nMETHODS\nThe literature related to OSA and male serum testosterone in the PubMed, Embase, and Cochrane Library databases were searched from their inception to June 10, 2021. Data were pooled using the Stata 15 software. We performed a subgroup analysis of studies after matching the age and body mass index (BMI), as well as according to the severity of OSA.\n\n\nRESULTS\nEighteen studies involving 1,823 men were included in the systematic review and meta-analysis. A significant inverse association between OSA and male serum testosterone (SMD = -0.76; 95% CI: -1.18, -0.33; P = 0.001) was found. After adjusting for age and BMI, this inverse association still existed (SMD = -0.8; 95% CI = -1.41, -0.18, P = 0.012). According to the subgroup analysis of OSA severity, our results showed that serum testosterone was not significantly decreased in mild (SMD = -0.58; 95% CI = -1.88, 0.73, P = 0.386) and moderate OSA patients (SMD = -0.94; 95% CI = -2.04, 0.15, P = 0.092), whereas it was significantly reduced in patients with severe OSA (SMD = -1.21; 95% CI = -2.02, -0.41, P = 0.003).\n\n\nCONCLUSIONS\nOSA is inversely associated with male serum testosterone levels, independent of BMI and age. Notably, the severity of OSA is also correlated with male serum testosterone, which is significantly reduced in patients with severe OSA. This article is protected by copyright. All rights reserved.