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APAP impact on metabolic syndrome in obstructive sleep apnea patients

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Abstract

Purpose

Prevalence of metabolic syndrome (MS) in obstructive sleep apnea (OSA) patients is high. The effect of autoadjusting positive airway pressure (APAP) on MS remains unclear. This study aimed to determine the prevalence of MS in OSA patients before and 6 months after APAP, and to identify potential determinants of metabolic status change.

Methods

Seventy-four male patients with moderate to severe OSA were enrolled. MS diagnosis was established according to the National Cholesterol Education Program/Adult Treatment Panel III. APAP was prescribed to all patients.

Results

In the studied population, mean age was 55.9 years (SD 10.7 years), median body mass index (BMI), Epworth sleepiness scale (ESS), and respiratory disturbance index (RDI) were 33.4 kg/m2 (interquartile range (IQR) 8.4 kg/m2), 12.0 (IQR 8.0), and 46.9/h (IQR 33.6/h), respectively. Prevalence of MS before and 6 months after APAP was 63.5% and 47.3%, respectively, and this difference was statistically significant (p = 0.004). In the subgroup of patients with MS at baseline (n = 47), 14 did not present MS after APAP. In these patients, a significant negative association with RDI (p = 0.016) and a positive association with percent of total days of usage (p = 0.014) were found. Blood pressure (p = 0.018) and serum triglycerides (p = 0.001) had a statistically significant reduction during this period. In patients that still had MS, 22.2% presented a reduction of the number of MS criteria.

Conclusions

After 6 months, APAP reduced the prevalence of MS, mainly in patients with less severe OSA and with a better therapeutic compliance. Blood pressure and serum triglycerides reduction contributed to this metabolic status change.

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Acknowledgements

The authors would like to sincerely thank nurses Emília Araújo and Paula Martins for their collaboration on blood sample collections, technician Delfim Souteiro for the 24-h ambulatory blood pressure measurements, as well as to all sleep technicians who manually reviewed all sleep studies.

Conflict of interest

Dr. Patrícia Caetano Mota has no conflict of interest that could inappropriately influence this study.

Prof. Marta Drummond has participated in speaking activities related to industry sources, receiving honoraria from AstraZeneca, MerckSharpDohme, and GlaxoSmithKline.

Prof. João Carlos Winck was sponsored by Respironics to attend a Sleep conference in Canada 2006 and has received honoraria from GlaxoSmithKline and Boehringer Ingelheim related to speaking activities about COPD and from Respironics about NIV.

Prof. Ana Cristina Santos has no conflict of interest that could inappropriately influence this study.

Dr. João Almeida has participated in speaking activities related to industry sources, receiving honoraria from Boeheringer Ingelheim, AstraZeneca, MerckSharpDohme, and GlaxoSmithKline.

Prof. José Agostinho Marques has no conflict of interest that could inappropriately influence this study.

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Authors and Affiliations

  1. Department of Pulmonology, Hospital de São João, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

    Patrícia Caetano Mota, Marta Drummond, João Carlos Winck, João Almeida & José Agostinho Marques

  2. Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

    Marta Drummond, João Carlos Winck & José Agostinho Marques

  3. Department of Hygiene and Epidemiology, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal

    Ana Cristina Santos

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  1. Patrícia Caetano Mota
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  2. Marta Drummond
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Correspondence to Patrícia Caetano Mota.

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Mota, P.C., Drummond, M., Winck, J.C. et al. APAP impact on metabolic syndrome in obstructive sleep apnea patients. Sleep Breath 15, 665–672 (2011). https://doi.org/10.1007/s11325-010-0417-5

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