title: Effect of continuous positive airway pressure treatment on serum cardiovascular risk factors in patients with obstructive sleep apnea-hypopnea syndrome.
abstract: 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.
authors.affiliation: Sleep Unit, George Papanikolaou General Hospital, Thessaloniki, Greece. pstirop@med.duth.gr
authors.forename: Paschalis
authors.initials: P
authors.lastname: Steiropoulos
authors.forename: Venetia
authors.initials: V
authors.lastname: Tsara
authors.forename: Evangelia
authors.initials: E
authors.lastname: Nena
authors.forename: Christina
authors.initials: C
authors.lastname: Fitili
authors.forename: Margarita
authors.initials: M
authors.lastname: Kataropoulou
authors.forename: Marios
authors.initials: M
authors.lastname: Froudarakis
authors.forename: Pandora
authors.initials: P
authors.lastname: Christaki
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Bouros
mesh_terms: 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*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008055:Lipids; D006710:Homocysteine; D002097:C-Reactive Protein