Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang District, Fuzhou, 350005, China.
The Second Affiliated Hospital of Fujian Medical University, No. 34 Zhongshan North Road, Licheng District, Quanzhou, 362000, China.
Sleep Breath. 2020 Jun;24(2):425-432. doi: 10.1007/s11325-019-01932-1. Epub 2019 Aug 28.
The efficacy of obstructive sleep apnea (OSA) treatment with continuous positive airway pressure (CPAP) on visceral adipose tissue (VAT) yielded conflicting results. This meta-analysis was performed to assess whether OSA treatment with CPAP could reduce VAT.
The PubMed, Cochrane Library, Embase, and Web of Science were searched before April 2019. Information on characteristics of study participants, pre- and post-CPAP treatment of VAT, and study design was utilized for analysis. Standardized mean difference (SMD) and 95% confidence interval (CI) were used to fully analyze the overall effects. Eleven studies were obtained and the meta-analysis was performed using RevMan v.5.2 and STATA 12.0.
A total of 11 studies (16 cohorts) were pooled into meta-analysis, which included 398 patients. The value of VAT before and after CPAP treatment showed no change in OSA patients (SMD = - 0.02, 95% CI - 0.16 to 0.12, z = 0.24, p = 0.81). Subgroup analyses were further conducted, which revealed that age, gender distribution, baseline body mass index, daily duration, CPAP therapy duration, measure, sample size, and study design did not affect the results.
This meta-analysis revealed that CPAP therapy has no effect on VAT in OSA patients. Further large-scale, well-designed randomized controlled trials are required to address this issue.
持续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停（OSA）对内脏脂肪组织（VAT）的疗效结果相互矛盾。进行这项荟萃分析旨在评估 CPAP 治疗 OSA 是否可以减少 VAT。
检索了 2019 年 4 月之前的 PubMed、Cochrane 图书馆、Embase 和 Web of Science，利用研究参与者特征、CPAP 治疗前后的 VAT 以及研究设计等信息进行分析。采用标准化均数差（SMD）和 95%置信区间（CI）进行完全分析。共纳入 11 项研究，使用 RevMan v.5.2 和 STATA 12.0 进行荟萃分析。
共有 11 项研究（16 个队列）纳入荟萃分析，共纳入 398 例患者。CPAP 治疗前后的 VAT 值在 OSA 患者中没有变化（SMD=-0.02，95%CI-0.16 至 0.12，z=0.24，p=0.81）。进一步进行了亚组分析，结果表明年龄、性别分布、基线体重指数、每日持续时间、CPAP 治疗持续时间、测量方法、样本量和研究设计均不会影响结果。
这项荟萃分析表明 CPAP 治疗对 OSA 患者的 VAT 没有影响。需要进一步开展大规模、精心设计的随机对照试验来解决这个问题。
