Sleep and Biological Rhythms

, Volume 14, Issue 3, pp 287–293 | Cite as

No elevation of serum adiponectin in OSA patients after continuous positive airway pressure treatment: a meta-analysis

  • Zhijun Li
  • Wenjuan Wu
  • Li Yang
  • Liang Gu
  • Tian Zhao
  • Tingyu Tang
  • Xiaoxi Zhou
  • Guangyue Qin
Original Article

Abstract

It is reported that the level of serum adiponectin is closely associated with status of obstructive sleep apnea (OSA). However, the effect of continuous positive airway pressure (CPAP) on adiponectin concentration remains controversial. Therefore, the aim of study is to testify the hypothesis that there is a systematic elevation in serum adiponectin with CPAP. We reviewed relevant studies by searching Medline, Pubmed, Embase, and the Cochrane library from 2006 to 2014. Eligible studies which focused on effects of CPAP on adiponectin levels in OSA patients, were identified by two independent reviewers. RevMan and STATA software were utilized for data synthesis and analysis. Association between CPAP and adiponectin was evaluated by polled analysis, and subgroup analysis, basing on detection method, duration of CPAP, sample size, body mass index (BMI), apnea hypopnea index and regional distribution. In total 10 articles were enrolled into the meta-analysis. The results demonstrated that standardised mean difference of the adiponectin levels pre- and post-CPAP therapy was −0.04 (95 % CI −0.21 to 0.12), test for overall effect z = 0.49 (P = 0.62). Subgroup analysis showed that differences in detection method, duration of CPAP, sample size, BMI, OSA severity and regional distribution did not affect the results of polled analysis. The study demonstrated that there was no systematic change in serum adiponectin with CPAP in OSA patients.

Keywords

Obstructive sleep apnea Continuous positive airway pressure Adiponectin Meta-analysis 

Notes

Compliances with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Ryan S, Crinion SJ, McNicholas WT. Obesity and sleep-disordered breathing–when two ‘bad guys’ meet. QJM. 2014;107:949–54.CrossRefPubMedGoogle Scholar
  2. 2.
    Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006–14.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Vionnet N, Hani EH, Dupont S, Gallina S, Francke S, Dotte S, De Matos F, Durand E, Leprêtre F, Lecoeur C. Genomewide search for type 2 diabetes-susceptibility genes in French whites: evidence for a novel susceptibility locus for early-onset diabetes on chromosome 3q27-qter and independent replication of a type 2-diabetes locus on chromosome lq21-q24. Am J Hum Genet. 2000;67:1470–80.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Lam JC, Xu A, Tam S, Khong PI, Yao TJ, Lam DC, Lai AY, Lam B, Lam KS, Mary SM. Hypoadiponectinemia is related to sympathetic activation and severity of obstructive sleep apnea. Sleep. 2008;31:1721–7.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Alfadda AA. Circulating adipokines in healthy versus unhealthy overweight and obese subjects. Int J Endocrinol. 2014;2014:170434.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Rojas E, Rodríguez-Molina D, Bolli P, Israili ZH, Faría J, Fidilio E, Bermúdez V, Velasco M. The role of adiponectin in endothelial dysfunction and hypertension. Curr Hypertens Rep. 2014;16:463.CrossRefPubMedGoogle Scholar
  7. 7.
    Vatansever E, Surmen-Gur E, Ursavas A, Karadag M. Obstructive sleep apnea causes oxidative damage to plasma lipids and proteins and decreases adiponectin levels. Sleep Breath. 2011;15:275–82.CrossRefPubMedGoogle Scholar
  8. 8.
    Al Mutairi S, Mojiminiyi OA, Al Alawi A, Al Rammah T, Abdella N. Study of leptin and adiponectin as disease markers in subjects with obstructive sleep apnea. Dis Markers. 2014;2014:706314. doi: 10.1155/2014/706314.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Masserini B, Morpurgo PS, Donadio F, Baldessari C, Bossi R, Beck-Peccoz P, Orsi E. Reduced levels of adiponectin in sleep apnea syndrome. J Endocrinol Invest. 2006;29:700–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Vgontzas AN, Zoumakis E, Bixler EO, Lin HM, Collins B, Basta M, Pejovic S, Chrousos GP. Selective effects of CPAP on sleep aponea-associated manifestations. Eur J Clin Invest. 2008;38:585–95.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Sánchez-de-la-Torre M, Mediano O, Barceló A, Piérola J, de la Peña M, Esquinas C, Miro A, Durán-Cantolla J, Agustí AG, Capote F. The influence of obesity and obstructive sleep apnea on metabolic hormones. Sleep Breath. 2012;16:649–56.CrossRefPubMedGoogle Scholar
  12. 12.
    Yoshikawa M, Yamauchi M, Fujita Y, Koyama N, Fukuoka A, Tamaki S, Yamamoto Y, Tomoda K, Kimura H. The impact of obstructive sleep apnea and nasal CPAP on circulating adiponectin levels. Lung. 2014;192:289–95.CrossRefPubMedGoogle Scholar
  13. 13.
    Zhang XL, Yin KS, Li C, Jia EZ, Li YQ, Gao ZF. Effect of continuous positive airway pressure treatment on serum adiponectin level and mean arterial pressure in male patients with obstructive sleep apnea syndrome. Chin Med J (Engl). 2007;120:1477–81.Google Scholar
  14. 14.
    Garcia JM, Sharafkhaneh H, Hirshkowitz M, Elkhatib R, Sharafkhaneh A. Weight and metabolic effects of CPAP in obstructive sleep apnea patients with obesity. Respir Res. 2011;12:80.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Takahashi K, Chin K, Nakamura H, Morita S, Sumi K, Oga T, Matsumoto H, Niimi A, Fukuhara S, Yodoi J. Plasma thioredoxin, a novel oxidative stress marker, in patients with obstructive sleep apnea before and after nasal continuous positive airway pressure. Antioxid Redox Signal. 2008;10:715–26.Google Scholar
  16. 16.
    Kritikou I, Basta M, Vgontzas AN, Pejovic S, Liao D, Tsaoussoglou M, Bixler EO, Stefanakis Z, Chrousos GP. Sleep apnoea, sleepiness, inflammation and insulin resistance in middle-aged males and females. Eur Respir J. 2014;43:145–55.CrossRefPubMedGoogle Scholar
  17. 17.
    Sumi K, Chin K, Takahashi K, Nakamura T, Matsumoto H, Niimi A, Mishima M. Effect of nCPAP therapy on heart rate in patients with obstructive sleep apnoea-hypopnoea. QJM. 2006;99:545–53.CrossRefPubMedGoogle Scholar
  18. 18.
    Kohler M, Ayers L, Pepperell JC, Packwood KL, Ferry B, Crosthwaite N, Craig S, Siccoli MM, Davies RJ, Stradling JR. Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomized trial. Thorax. 2009;64:67–73.CrossRefPubMedGoogle Scholar
  19. 19.
    Murri M, Alcázar-Ramírez J, Garrido-Sánchez L, Linde F, Alcaide J, Cardona F, Tinahones FJ. Oxidative stress and metabolic changes after continuous positive airway pressure treatment according to previous metabolic disorders in sleep apnea-hypopnea syndrome patients. Transl Res. 2009;154:111–21.CrossRefPubMedGoogle Scholar
  20. 20.
    Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50:1088–101.CrossRefPubMedGoogle Scholar
  23. 23.
    West SD, Nicoll DJ, Wallace TM, Matthews DR, Stradling JR. Effect of CPAP on insulin resistance and HbA1c in men withobstructive sleep apnoea and type 2 diabetes. Thorax. 2007;62:969–74.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Harsch IA, Wallaschofski H, Koebnick C, Pour Schahin S, Hahn EG, Ficker JH, Lohmann T. Adiponectin in patients with obstructive sleep apnea syndrome: course and physiological relevance. Respiration. 2004;71:580–6.CrossRefPubMedGoogle Scholar
  25. 25.
    Nakagawa Y, Kishida K, Kihara S, Sonoda M, Hirata A, Yasui A, Nishizawa H, Nakamura T, Yoshida R, Shimomura I. Nocturnal reduction in circulating adiponectin concentrations related to hypoxic stress in severe obstructive sleep apnea-hypopnea syndrome. Am J Physiol Endocrinol Metab. 2008;294:E778–84.CrossRefPubMedGoogle Scholar
  26. 26.
    Li AM, Ng C, Ng SK, Chan MM, So HK, Chan I, Lam CW, Ng PC, Wing YK. Adipokines in children with obstructive sleep apnea and the effects of treatment. Chest. 2010;137:529–35.CrossRefPubMedGoogle Scholar
  27. 27.
    Patel SR, White DP, Malhotra A, Stanchina ML, Ayas NT. Continuous positive airway pressure therapy for treating sleepiness in a diverse population with obstructive sleep apnea: result of a meta-analysis. Arch Intern Med. 2003;163:565–71.CrossRefPubMedGoogle Scholar
  28. 28.
    Guo Y, Pan L, Ren D, Xie X. Impact of continuous positive airway pressure on C-reactive protein in patients with obstructive sleep apnea: a meta-analysis. Sleep Breath. 2013;17:495–503.CrossRefPubMedGoogle Scholar
  29. 29.
    Byun SH, Kwon EB, Kim SY. The relationship between serum adiponectin and inflammatory cytokines in obese Korean juveniles. Korean J Pediatr. 2014;57:533–7.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Aleidi S, Issa A, Bustanji H, Khalil M, Bustanji Y. Adiponectin serum levels correlate with insulin resistance in type 2 diabetic patients. Saudi Pharm J. 2015;23(3):250–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Börgeson E, Johnson AM, Lee YS, Till A, Syed GH, Ali-Shah ST, Guiry PJ, Dalli J, Colas RA, Serhan CN. Lipoxin A4 attenuates obesity-induced adipose inflammation and associated liver and kidney disease. Cell Metab. 2015;22(1):125–37.CrossRefPubMedGoogle Scholar
  32. 32.
    Khoo J, Dhamodaran S, Chen DD, Yap SY, Chen RY, Tian HH. Exercise-induced weight loss is more effective than dieting for improving adipokine profile, insulin resistance and inflammation in obese men. Int J Sport Nutr Exerc Metab. 2015;25:566–75.CrossRefPubMedGoogle Scholar
  33. 33.
    Ozdemir D, Dagdelen S, Usman A. Serum adiponectin levels and changes in glucose metabolism before and after treatment for thyroid dysfunction. Intern Med. 2015;54:1849–57.CrossRefPubMedGoogle Scholar
  34. 34.
    Wolk R, Svatikova A, Nelson CA, Gami AS, Govender K, Winnicki M, Somers VK. Plasma levels of adiponectin, a novel adipocyte-derived hormone, in sleep apnea. Obes Res. 2005;13:186–90.CrossRefPubMedGoogle Scholar
  35. 35.
    Li P, Jiang R, Li L, Liu C, Yang F, Qiu Y. Correlation of serum adiponectin and adiponectin gene polymorphism with metabolic syndrome in Chinese adolescents. Eur J Clin Nutr. 2015;69:62–7.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Sleep Research 2016

Authors and Affiliations

  • Zhijun Li
    • 1
  • Wenjuan Wu
    • 1
  • Li Yang
    • 1
  • Liang Gu
    • 1
  • Tian Zhao
    • 1
  • Tingyu Tang
    • 1
  • Xiaoxi Zhou
    • 1
  • Guangyue Qin
    • 1
  1. 1.Department of Respiratory Medicine of Zhejiang HospitalHangzhouChina

Personalised recommendations