Xu Huajun, Yi Hongliang, Guan Jian, Yin Shankai
Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China.
Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Otolaryngology Institute of Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China.
Atherosclerosis. 2014 Jun;234(2):446-53. doi: 10.1016/j.atherosclerosis.2014.03.034. Epub 2014 Apr 12.
Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for development of dyslipidemia. Continuous positive airway pressure (CPAP) is the first-line treatment for OSAS. However, it is unclear whether CPAP improves lipid metabolism.
To review the effect of CPAP on lipid profile of patients with OSAS.
We searched PubMed, Embase, and the Cochrane Library to identify eligible articles published prior to October 30, 2013. Six randomized controlled trials (RCTs) were subjected to meta-analysis using Comprehensive Meta-Analysis software.
Six RCTs meeting the inclusion criteria were enrolled. The total numbers of measurements of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol, in CPAP intervention patients and sham/control groups, were 370 and 371, 330 and 328, 276 and 274, and 269 and 266 respectively. The pooled estimate of the difference in the mean TC level between the CPAP and sham CPAP/control groups was significantly different (-0.15 [95% confidence interval, -0.27 to -0.03]; p = 0.01). Subgroup analysis revealed that OSAS patients of younger age, who were more obese, and who had been treated via CPAP for a longer duration, showed a significant decrease in TC levels (the differences in the means were -0.27, -0.24, and -0.20; and the p values 0.001, 0.01, and 0.04, respectively).
We confirmed that CPAP decreases the TC level, especially in OSAS patients who are younger, more obese, and who use CPAP for a longer period. CPAP did not alter TG, LDL, or HDL levels, suggesting that CPAP may have no clinically important effect on lipid metabolism.
阻塞性睡眠呼吸暂停综合征（OSAS）是血脂异常发生的一个独立危险因素。持续气道正压通气（CPAP）是OSAS的一线治疗方法。然而，CPAP是否能改善脂质代谢尚不清楚。
综述CPAP对OSAS患者血脂水平的影响。
我们检索了PubMed、Embase和Cochrane图书馆，以识别2013年10月30日前发表的符合条件的文章。使用综合荟萃分析软件对六项随机对照试验（RCT）进行荟萃分析。
纳入了六项符合纳入标准的RCT。CPAP干预组和假手术/对照组中，总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）胆固醇和高密度脂蛋白（HDL）胆固醇的测量总数分别为370和371、330和328、276和274、269和266。CPAP组与假CPAP/对照组之间平均TC水平差异的合并估计值有显著差异（-0.15[95%置信区间，-0.27至-0.03]；p = 0.01）。亚组分析显示，年龄较轻、肥胖程度较高且接受CPAP治疗时间较长的OSAS患者，其TC水平显著降低（均值差异分别为-0.27、-0.24和-0.20；p值分别为0.001、0.01和0.04）。
我们证实CPAP可降低TC水平，尤其是在年龄较轻、肥胖程度较高且使用CPAP时间较长的OSAS患者中。CPAP未改变TG、LDL或HDL水平，这表明CPAP可能对脂质代谢没有临床重要影响。
