Relationship between aldosterone and the metabolic syndrome in patients with obstructive sleep apnea hypopnea syndrome: effect of continuous positive airway pressure treatment.
BACKGROUND
Metabolic syndrome (MS) occurs frequently in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). We hypothesized that aldosterone levels are elevated in OSAHS and associated with the presence of MS.


METHODS
We studied 66 patients with OSAHS (33 with MS and 33 without MS) and 35 controls. The occurrence of the MS was analyzed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) clinical criteria. Measurements of plasma renin activity (PRA), aldosterone, aldosterone:PRA ratio, creatinine, glucose, triglycerides, cholesterol and HDL cholesterol were obtained at baseline and after CPAP treatment.


RESULTS
Aldosterone levels were associated with the severity of OSAHS and higher than controls (p = 0.046). Significant differences in aldosterone levels were detected between OSAHS patients with and without MS (p = 0.041). A significant reduction was observed in the aldosterone levels in patients under CPAP treatment (p = 0.012).


CONCLUSIONS
This study shows that aldosterone levels are elevated in OSAHS in comparison to controls, and that CPAP therapy reduces aldosterone levels. It also shows that aldosterone levels are associated with the presence of metabolic syndrome, suggesting that aldosterone excess might predispose or aggravate the metabolic and cardiovascular complications of OSAHS.


BACKGROUND
The study is not a randomized controlled trial and was not registered.
Servei d'Anàlisis Cliniques, Hospital Universitari Son Espases, Palma de Mallorca; Servei de Pneumologia, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Illes Balears, Spain.
Antonia
A
Barceló
Unitat d'Investigació Hospital Universitari Son Espases, Palma de Mallorca; Servei de Pneumologia, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Illes Balears, Spain.
Javier
J
Piérola
Hospital Arnau de Vilanova/Santa Maria, Lleida, Spain.
Cristina
C
Esquinas
Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca; Servei de Pneumologia, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Illes Balears, Spain.
Mónica
M
de la Peña
Unitat d'Investigació Hospital Universitari Son Espases, Palma de Mallorca; Servei de Pneumologia, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Illes Balears, Spain.
Meritxell
M
Arqué
Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca; Servei de Pneumologia, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Illes Balears, Spain.
Alberto
A
Alonso-Fernández
Servei d'Anàlisis Cliniques, Hospital Universitari Son Espases, Palma de Mallorca; Servei de Pneumologia, Spain.
Josep Miquel
JM
Bauçà
Servei d'Anàlisis Cliniques, Hospital Universitari Son Espases, Palma de Mallorca; Servei de Pneumologia, Spain.
Juan
J
Robles
Servei d'Anàlisis Cliniques, Hospital Universitari Son Espases, Palma de Mallorca; Servei de Pneumologia, Spain.
Bernardino
B
Barceló
Hospital Arnau de Vilanova/Santa Maria, Lleida, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Mallorca, Illes Balears, Spain.
Ferran
F
Barbé
D000328:Adult; D000450:Aldosterone / Q000097:blood*; D045422:Continuous Positive Airway Pressure; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000097:blood*
D000450:Aldosterone