APAP impact on metabolic syndrome in obstructive sleep apnea patients.
OBJECTIVE
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/m(2) (interquartile range (IQR) 8.4 kg/m(2)), 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.
Mota
Patrícia Caetano
PC
Department of Pulmonology, Hospital de São João, Porto, Portugal. patmota@net.sapo.pt
Drummond
Marta
M
Winck
João Carlos
JC
Santos
Ana Cristina
AC
Almeida
João
J
Marques
José Agostinho
JA
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides