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Effects of mandibular advancement device treatment on arterial stiffness and glucose metabolism in patients with mild to moderate obstructive sleep apnea: a prospective 1 year study

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Abstract

Study objectives

An independent association between obstructive sleep apnea (OSA) and cardiovascular events has been reported, suggesting that OSA may lead to cardiometabolic dysregulation. We prospectively investigated the effect of mandibular advancement device (MAD) treatment on arterial stiffness, glucose metabolism, and certain inflammatory markers as predictors of cardiometabolic risk in mild to moderate OSA patients.

Methods

A total of 18 patients with mild to moderate OSA were prospectively enrolled in the study to determine the effects of MAD treatment at 3 months and 1 year following initiation of the treatment. Sleep studies, arterial stiffness assessment, and laboratory analyses were obtained at the baseline and at the time of follow-up. The data collected at 1 year were compared to baseline values.

Results

There was a significant decrease in apnea-hypopnea index (AHI) after 1 year of treatment when compared to baseline (22.9 ± 5.9 to 9.7 ± 4.5, P < 0.001). Furthermore, MAD treatment was associated with reduced levels of fasting plasma glucose values after 1 year of treatment (5.3 ± 0.5 to 4.9 ± 0.5 mmol/L, P < 0.001), as well as fasting plasma insulin values (14.1 ± 7.8 to 10.9 ± 6.4 μU/mL, P < 0.05) and HOMA-IR (3.3 ± 1.8 to 2.4 ± 1.4, P < 0.001). There was significant improvement in pulse wave velocity (9.3 ± 1.9 m/s at baseline to 8.1 ± 1.7 m/s, P < 0.05) after 1 year of treatment. Plasma level of an inflammatory marker fibrinogen decreased significantly from 3.4 ± 0.7 at baseline to 3.0 ± 0.9, (P < 0.05) at 1-year follow-up.

Conclusions

The MAD treatment improved arterial stiffness, glucose metabolism, and insulin resistance in mild to moderate OSA patients after 1 year of treatment.

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Acknowledgments

The authors wish to thank Ivan Galic, DMD and Mijo Mario Vuletic, CDT for their assistance during dental examinations of patients and fabricating oral appliances. This work has been supported by the Croatian Ministry of Science, Education and Sport Grant #216-2163166-0513.

Conflict of interest

The authors declare they have no financial or material conflict of interest.

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Authors and Affiliations

  1. Study of Dental Medicine, University of Split School of Medicine, Soltanska 2, Split, Croatia

    Tea Galic

  2. Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, Split, Croatia

    Josko Bozic & Tina Kurir Ticinovic

  3. Split Sleep Medicine Center, University of Split School of Medicine, Soltanska 2, Split, Croatia

    Natalija Ivkovic & Zoran Dogas

  4. Department of Pharmacology, University of Split School of Medicine, Soltanska 2, Split, Croatia

    Grgo Gunjaca

  5. Department of Neuroscience, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia

    Zoran Dogas

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  1. Tea Galic
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  2. Josko Bozic
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  3. Natalija Ivkovic
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  4. Grgo Gunjaca
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  5. Tina Kurir Ticinovic
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  6. Zoran Dogas
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Correspondence to Zoran Dogas.

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Galic, T., Bozic, J., Ivkovic, N. et al. Effects of mandibular advancement device treatment on arterial stiffness and glucose metabolism in patients with mild to moderate obstructive sleep apnea: a prospective 1 year study. Sleep Breath 20, 69–77 (2016). https://doi.org/10.1007/s11325-015-1186-y

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  • DOI: https://doi.org/10.1007/s11325-015-1186-y

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