Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
Centre for Research and Development, Uppsala University, Region Gävleborg, Gävle, Sweden.
J Clin Sleep Med. 2018 Mar 15;14(3):385-391. doi: 10.5664/jcsm.6982.
Obstructive sleep apnea (OSA) is a disease with metabolic and cardiovascular consequences and is associated with decreased serum concentrations of insulin-like growth factor-1 (IGF-1). The aim of this study was to investigate whether continuous positive airway pressure (CPAP) will increase serum IGF-1 concentration in patients with OSA.
Patients with moderate to severe OSA were recruited from a sleep clinic and serum IGF-1 was measured before initiation of CPAP and at follow-up after 4.8 ± 2.5 months. Patients adherent to CPAP treatment (usage ≥ 4 h/night) were compared with those considered to be nonadherent (usage < 4 h/night).
Complete data were obtained from 69 patients (86% male, age 56 ± 12 years, respiratory event index 43 ± 21 events/h, Epworth Sleepiness Scale score 12 ± 5). In those adherent to CPAP (n = 42), there was an increase in serum IGF-1 concentration with 21.1 (95% confidence interval [CI]: 13.1 to 29.2) μg/L compared to 4.7 (95% CI: -4.1 to 13.5) μg/L in the nonadherent group (n = 27) ( = .0083). In a linear multivariate model adjusting for sex, age, body mass index, respiratory event index, and mean oxygen saturation during the night recording, the change in serum IGF-1 concentration was significantly associated with adherence to CPAP treatment (adjusted β coefficient: 21.8, 95% CI: 10.2 to 33.4) and inversely associated with change in body mass index (adjusted β coefficient: -7.1, 95% CI: -11.3 to -3.0) and change in hemoglobin A1c (adjusted β coefficient: -1.8, 95% CI: -33 to -0.3).
CPAP usage ≥ 4 h/night is associated with increased serum IGF-1 concentration in male patients with OSA.
阻塞性睡眠呼吸暂停（OSA）是一种具有代谢和心血管后果的疾病，与胰岛素样生长因子-1（IGF-1）血清浓度降低有关。本研究旨在探讨持续气道正压通气（CPAP）是否会增加 OSA 患者的血清 IGF-1 浓度。
从中度至重度 OSA 睡眠诊所招募患者，并在开始 CPAP 治疗前和 4.8 ± 2.5 个月后的随访时测量血清 IGF-1。将 CPAP 治疗依从性（使用时间≥4 小时/夜）的患者与被认为不依从（使用时间<4 小时/夜）的患者进行比较。
从 69 名患者（86%为男性，年龄 56 ± 12 岁，呼吸事件指数 43 ± 21 次/小时，Epworth 睡眠量表评分为 12 ± 5）中获得完整数据。在依从 CPAP 治疗的患者（n=42）中，血清 IGF-1 浓度增加了 21.1（95%置信区间 [CI]：13.1 至 29.2）μg/L，而不依从 CPAP 治疗的患者（n=27）中增加了 4.7（95% CI：-4.1 至 13.5）μg/L（=.0083）。在调整性别、年龄、体重指数、夜间记录期间呼吸事件指数和平均氧饱和度的线性多元模型中，血清 IGF-1 浓度的变化与 CPAP 治疗的依从性显著相关（调整β系数：21.8，95% CI：10.2 至 33.4），与体重指数的变化呈负相关（调整β系数：-7.1，95% CI：-11.3 至 -3.0）和血红蛋白 A1c 的变化（调整β系数：-1.8，95% CI：-33 至 -0.3）。
CPAP 使用时间≥4 小时/夜与男性 OSA 患者血清 IGF-1 浓度升高有关。
