Effect of Continuous Positive Airway Pressure on Glucose and Lipid Profiles in Patients With Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Filippo Cattazzo [1] ; Martino F. Pengo [3] ; Alice Giontella [1] ; Davide Soranna [4] ; Grzegorz Bilo [3] ; Antonella Zambon [4] ; Janaka Karalliedde [2] ; Luigi Gnudi [2] ; Miguel Ángel Martinez-Garcia [5] ; Pietro Minuz [1] ; Carolina Lombardi [3] ; Gianfranco Parati [3] ; Cristiano Fava [1]
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[1] University of Verona
University of Verona
Verona, Italia
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[2] King's College London
King's College London
Reino Unido
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[3] IRCCS, Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy
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[4] IRCCS, Istituto Auxologico Italiano, Biostatistics Unit, Milan, Italy
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[5] Departamento de Neumología, Hospital Universitari i Politècnic la Fe, Valencia, España
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- Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 59, Nº. 6 (June), 2023, págs. 370-376
- Idioma: inglés
- Texto completo no disponible (Saber más ...)
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Resumen
Background and aim Continuous Positive Airway Pressure (CPAP) is the most effective therapy for symptomatic obstructive sleep apnoea (OSA). However, uncertainty remains about the effectiveness of CPAP in improving OSA-related metabolic dysregulation. This meta-analysis of randomized controlled trials (RCTs) aimed to investigate whether CPAP, compared to other control treatments, could improve glucose or lipid metabolism in OSA patients.
Methods Relevant articles were searched in three different databases (MEDLINE, EMBASE and Web of Science) from inception to 6th Feb 2022 through specific search terms and selection criteria.
Results From a total of 5553 articles, 31 RCTs were included. CPAP modestly improved insulin sensitivity as determined by mean fasting plasma insulin and Homeostasis Model Assessment of Insulin Resistance reduction of 1.33mU/L and 0.287, respectively. In subgroup analyses pre-diabetic/type 2 diabetic patients as well as those with sleepy OSA showed a greater response to CPAP. Regarding lipid metabolism, CPAP was associated with a mean total cholesterol reduction of 0.064mmol/L. In subgroup analyses, the benefit was higher in patients that showed more severe OSA and oxygen desaturations at the baseline sleep study as well as in younger and obese subjects. Neither glycated haemoglobin nor triglycerides, HDL- and LDL-cholesterol were reduced by CPAP.
Conclusion CPAP treatment may improve insulin sensitivity and total cholesterol levels in OSA patients but with low effect size. Our results suggest that CPAP does not substantially improve metabolic derangements in an unselected OSA population, but the effect may be higher in specific subgroups of OSA patients.
