Oktay B, Akbal E, Firat H, Ardiç S, Kizilgun M
Department of Chest Medicine and Steep Medicine Center, Diskapi Yildirim Beyazit Egitim ve Arastirma Hastanesi, Ankara, Turkiye.
Acta Clin Belg. 2009 Jul-Aug;64(4):329-34. doi: 10.1179/acb.2009.051.
To investigate the effect of one year continuous positive airway pressure (CPAP) treatment on metabolic syndrome (MS) prevalence and components in patients diagnosed with both obstructive sleep apnea syndrome (OSAS) and metabolic syndrome.
This was a single center, observational prospective cohort study. 38 patients who were diagnosed with OSAS after polysomnographic analysis in sleep laboratory and diagnosed with MS according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guideline and underwent CPAP treatment were followed for one year. After the 1 year of follow up period on CPAP treatment, the prevalence of MS was evaluated again.
20 (13 male, 7 female) of 38 patients completed the entire study. Mean age was 50+/-7.7.4 patients were under treatment for diabetes mellitus (DM), 9 for hypertension (HT). After one year of follow up on CPAP treatment, the prevalence of MS decreased by 45%. When each components of MS were evaluated, no significant difference was found in fasting blood glucose, triglyceride levels and systolic and diastolic blood pressure after treatment (p>0.05). However, significant difference was observed in waist circumference (p=0.002), HDL cholesterol (p=0.001) and BMI (p=0.01) after treatment.
If MS accompanies OSAS, which is a cardiovascular risk factor by itself, treatment indications of CPAP should be reevaluated. Thus, if OSA patients meet the criteria of MS even though they do not have obvious DM, HT and hyperlipidemia, initiating CPAP treatment at lower AHI levels may contribute to the prevention and development of cardiovascular disease.
探讨持续气道正压通气(CPAP)治疗一年对同时诊断为阻塞性睡眠呼吸暂停综合征(OSAS)和代谢综合征的患者代谢综合征(MS)患病率及各组分的影响。
这是一项单中心、观察性前瞻性队列研究。对38例在睡眠实验室经多导睡眠图分析诊断为OSAS且根据美国国家胆固醇教育计划成人治疗组第三次报告(NCEP ATP III)指南诊断为MS并接受CPAP治疗的患者进行了为期一年的随访。在CPAP治疗随访一年后,再次评估MS的患病率。
38例患者中有20例(13例男性,7例女性)完成了整个研究。平均年龄为50±7.7岁。4例患者正在接受糖尿病(DM)治疗,9例患者正在接受高血压(HT)治疗。经过一年的CPAP治疗随访,MS的患病率下降了45%。当评估MS的各个组分时,治疗后空腹血糖、甘油三酯水平以及收缩压和舒张压均未发现显著差异(p>0.05)。然而,治疗后腰围(p=0.002)、高密度脂蛋白胆固醇(p=0.001)和体重指数(p=0.01)出现了显著差异。
如果MS伴有OSAS(OSAS本身就是一种心血管危险因素),应重新评估CPAP的治疗指征。因此,如果OSA患者即使没有明显的DM、HT和高脂血症但符合MS的标准,在较低的呼吸暂停低通气指数(AHI)水平启动CPAP治疗可能有助于预防心血管疾病的发生和发展。