S Kanimozhi, C Balaji, A Saravanan, K Ravi
Assistant Professor, Department of Physiology, SRM MCH & RC , Chennai, India .
Associate Professor, Department of Paediatrics, SRM MCH & RC , Chennai, India .
J Clin Diagn Res. 2015 Apr;9(4):CC07-10. doi: 10.7860/JCDR/2015/13301.5859. Epub 2015 Apr 1.
Patients of obstructive sleep apnea (OSA) with metabolic syndrome (MetS) are at increased risk of cardiovascular morbidity and mortality. The role of oxidative stress in pathogenesis of OSA and MetS has been widely reported. Continuous positive airway pressure (CPAP) therapy remains the first-line of treatment in OSA. The beneficial effect of long term CPAP therapy in OSA is well-known. However, the effect of short term CPAP on the components of MetS and oxidative stress-antioxidant levels is still unclear.
The present study explored the effects of one night of CPAP therapy on the oxidant-antioxidant status and components of MetS in patients of OSA with MetS.
Twenty adult males and postmenopausal females with MetS and symptoms suggestive of OSA were enrolled in the study. None of the subjects were smoker or alcoholic. They did not consume any drugs that would alter their antioxidant levels. Overnight polysomnography was done to confirm diagnosis and assess CPAP pressure. Following which they spent one night in the sleep lab for CPAP therapy. Blood pressure data and blood samples were collected at baseline and after CPAP. Collected samples were transferred immediately to the laboratory for analysis of serum thiol, lipid peroxidation, insulin resistance (HOMA-IR) and lipid profile.
Paired t-test with two-tail significance was used to compare the changes in study parameters in the same patient before and after treatment. The antioxidant level increased and oxidative stress decreased as evidenced by serum thiol concentration (204.2±65.7 vs 254.9±72 μmol/L, p<0.001) and lipid peroxidation levels (13.1±6.2 vs 8.4±3.1 μmol/L, p<0.01).There was a significant decrease in both systolic (132.1±16.1 vs 127.2±14.3 mmHg, p<0.01) and diastolic blood pressure (86.4±9.4 vs 81.2±9.8 mmHg, p<0.01) after one night of CPAP. However, there was no change in lipid parameters and the reduction seen in insulin resistance was not statistically significant.
One night of CPAP therapy seems to be helpful in reducing oxidative stress, improving antioxidant levels and decreasing the severity of various components of MetS.
患有代谢综合征（MetS）的阻塞性睡眠呼吸暂停（OSA）患者发生心血管疾病和死亡的风险增加。氧化应激在OSA和MetS发病机制中的作用已被广泛报道。持续气道正压通气（CPAP）治疗仍然是OSA的一线治疗方法。长期CPAP治疗在OSA中的有益效果是众所周知的。然而，短期CPAP对MetS各组分和氧化应激-抗氧化水平的影响仍不清楚。
本研究探讨了一晚CPAP治疗对患有MetS的OSA患者氧化-抗氧化状态及MetS各组分的影响。
本研究纳入了20名患有MetS且有OSA症状的成年男性和绝经后女性。所有受试者均不吸烟、不饮酒。他们未服用任何会改变其抗氧化水平的药物。进行整夜多导睡眠图检查以确诊并评估CPAP压力。之后，他们在睡眠实验室接受一晚的CPAP治疗。在基线和CPAP治疗后采集血压数据和血样。采集的样本立即送往实验室分析血清硫醇、脂质过氧化、胰岛素抵抗（HOMA-IR）和血脂谱。
采用双侧显著性配对t检验比较同一患者治疗前后研究参数的变化。血清硫醇浓度（204.2±65.7 vs 254.9±72 μmol/L，p<0.001）和脂质过氧化水平（13.1±6.2 vs 8.4±3.1 μmol/L，p<0.01）表明抗氧化水平升高，氧化应激降低。一晚CPAP治疗后，收缩压（132.1±16.1 vs 127.2±14. mmHg，p<0.01）和舒张压（86.4±9.4 vs 81.2±9.8 mmHg，p<0.01）均显著降低。然而，血脂参数没有变化，胰岛素抵抗的降低无统计学意义。
一晚的CPAP治疗似乎有助于降低氧化应激、提高抗氧化水平并减轻MetS各组分的严重程度。
