Effect of continuous positive airway pressure treatment on serum cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea syndrome.
BACKGROUND
Serum levels of circulating markers associated with cardiovascular morbidity are elevated in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). These factors are studied in patients mainly before the application of therapy with continuous positive airway pressure (CPAP), and the effects of CPAP treatment on them have not been thoroughly studied. Therefore, the aim of the study was to examine the effect of compliance to CPAP therapy on these factors.


METHODS
Patients with newly diagnosed OSAHS, nonsmokers, without comorbidities or medication use, at baseline and during the follow-up period, were included. Serum cardiovascular risk factors (ie, high-sensitivity C-reactive protein [hs-CRP], homocysteine, total cholesterol, triglycerides, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol, apolipoprotein A-I [ApoA-I], and apolipoprotein B [ApoB]) were measured at baseline and 6 months after CPAP application. Patients were classified into the following three groups according to CPAP use: group 1 (n = 20), good compliance (>or= 4 h use per night); group 2 (n = 19), poor compliance (< 4 h use per night); and group 3 (n = 14), refusal of CPAP treatment.


RESULTS
Fifty-three patients (47 male patients and 6 female patients; mean [+/- SD] age, 46.09 +/- 10.87 years) were included in the study. In all groups, body mass index remained stable. In group 1, significant decreases in the levels of hs-CRP (p = 0.03), homocysteine (p = 0.005), total cholesterol (p = 0.021), total cholesterol/HDL-C ratio (p = 0.018), and ApoB/ApoA-I ratio (p = 0.021) was observed. The patients in group 2 showed a decrease in homocysteine levels (p = 0.021) only, while no significant changes were observed in the patients in group 3.


CONCLUSIONS
Good compliance to CPAP treatment lowers the serum levels of cardiovascular risk factors, indicating a beneficial effect on the overall cardiovascular risk.
Steiropoulos
Paschalis
P
Sleep Unit, George Papanikolaou General Hospital, Thessaloniki, Greece. pstirop@med.duth.gr
Tsara
Venetia
V
Nena
Evangelia
E
Fitili
Christina
C
Kataropoulou
Margarita
M
Froudarakis
Marios
M
Christaki
Pandora
P
Bouros
Demosthenes
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology; D045422:Continuous Positive Airway Pressure; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000523:psychology / Q000628:therapy*
D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids; D006710:Homocysteine; D002097:C-Reactive Protein