Nadeem Rashid, Singh Mukesh, Nida Mahwish, Kwon Sarah, Sajid Hassan, Witkowski Julie, Pahomov Elizabeth, Shah Kruti, Park William, Champeau Dan
Rosalind Franklin University of Medicine and Science, North Chicago, IL.
Rematul lil Alameen Institute of Cardiology, Lahore, Pakistan.
J Clin Sleep Med. 2014 Dec 15;10(12):1295-302. doi: 10.5664/jcsm.4282.
Patients with obstructive sleep apnea (OSA) frequently exhibit higher rates of dyslipidemia, a risk factor for cardiovascular and cerebrovascular disorders. Treatment for OSA by CPAP may improve cholesterol metabolism. This meta-regression analysis (MA) estimates the effect of CPAP treatment on dyslipidemia.
PubMed and Cochrane libraries were searched by utilizing different combinations of keywords: CPAP, obstructive sleep apnea, serum lipids, dyslipidemia, cholesterol, total cholesterol (TC), low density lipoprotein, LDL, high density lipoprotein, HDL, triglyceride, and TG. Inclusion criteria were: (1) English articles and (2) studies with an adult population with the diagnosis of OSA who were treated with CPAP. The OSA group must have cholesterol profile including TC, LDLc, HDLc, and TG, without and with CPAP treatment. Fifty-four studies were reviewed, while 29 studies pooled for MA.
Thirty-four datasets from 29 studies with 1,958 subjects pooled. Treatment duration range was from 2 days to 1 year. TC standardized mean differences (SMD) ranged from -41.5 to -0.077, pooled mean difference (PMD) was -5.660 (LL -6.715 to UL -4.606, p < 0.001). SMD in LDL ranged from -3.7 to 0; PMD was -0.488 (LL -0.715 to UL -0.261, p < 0.001). HDL SMD ranged from -0.498 to 1.94. The PMD was 0.207 (LL 0.05 to UL 0.364, p < 0.01). TG SMD ranged from -9.327 to 1.98; PMD was -0.054 (LL -0.124 to UL 0.016, p < 0.129).
CPAP treatment for OSA seems to improve dyslipidemia (decrease in total cholesterol and LDL, and increase in HDL). It does not appear to affect TG levels.
阻塞性睡眠呼吸暂停（OSA）患者常表现出较高的血脂异常发生率，而血脂异常是心脑血管疾病的一个危险因素。持续气道正压通气（CPAP）治疗OSA可能会改善胆固醇代谢。本荟萃回归分析（MA）评估CPAP治疗对血脂异常的影响。
通过使用不同的关键词组合在PubMed和Cochrane图书馆进行检索：CPAP、阻塞性睡眠呼吸暂停、血脂、血脂异常、胆固醇、总胆固醇（TC）、低密度脂蛋白、LDL、高密度脂蛋白、HDL、甘油三酯和TG。纳入标准为：（1）英文文章；（2）对诊断为OSA的成年人群进行CPAP治疗的研究。OSA组必须有包括TC、LDLc、HDLc和TG的血脂谱，且有未接受CPAP治疗和接受CPAP治疗的情况。共审查了54项研究，其中29项研究纳入荟萃分析。
来自29项研究的34个数据集纳入了1958名受试者。治疗持续时间范围为2天至1年。TC的标准化平均差（SMD）范围为-41.5至-0.077，合并平均差（PMD）为-5.660（下限-6.715至上限-4.606，p<0.001）。LDL的SMD范围为-3.7至0；PMD为-0.488（下限-0.715至上限-0.261，p<0.001）。HDL的SMD范围为-0.498至1.94。PMD为0.207（下限0.05至上限0.364，p<0.01）。TG的SMD范围为-9.327至1.98；PMD为-0.054（下限-0.124至上限0.016，p<0.129）。
CPAP治疗OSA似乎可改善血脂异常（总胆固醇和LDL降低，HDL升高）。它似乎不影响TG水平。
