Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Diagnostic Centre, Regional Hospital Silkeborg, Silkeborg, Denmark.
J Sleep Res. 2020 Aug;29(4):e12978. doi: 10.1111/jsr.12978. Epub 2020 Mar 12.
The objective of this study was to evaluate the effect of continuous positive airway pressure treatment on pulse wave velocity and blood pressure in patients with type 2 diabetes and obstructive sleep apnea. A randomized controlled study was performed, including 72 patients with type 2 diabetes and newly diagnosed obstructive sleep apnea recruited from outpatient clinics at three Danish hospitals. The patients were randomized to continuous positive airway pressure for 12 weeks or no continuous positive airway pressure. Office measurements were performed at baseline, 4 weeks and 12 weeks. At baseline and 12 weeks, a 24-hr measurement of pulse wave velocity and blood pressure was performed. No significant change was observed in the primary outcome variable of carotid-femoral pulse wave velocity measured with SphygmoCor. With the Mobil-O-Graph, changes in office pulse wave velocity between the groups were significant: 0.3 m/s; 95% confidence interval, 0.1-0.6; p = .02. The group receiving continuous positive airway pressure had a larger decrease in pulse wave velocity than controls but none of the changes within the groups were significant. No significant change in ambulatory blood pressure was observed in any of the two groups after 12 weeks. In conclusion, continuous positive airway pressure treatment for 12 weeks does not significantly reduce pulse wave velocity or blood pressure in patients with type 2 diabetes and obstructive sleep apnea.
本研究旨在评估持续气道正压通气治疗对 2 型糖尿病合并阻塞性睡眠呼吸暂停患者脉搏波速度和血压的影响。采用随机对照研究,纳入了 3 家丹麦医院门诊新诊断为阻塞性睡眠呼吸暂停的 72 例 2 型糖尿病患者。患者被随机分为持续气道正压通气 12 周组或不接受持续气道正压通气组。在基线、4 周和 12 周时进行诊室测量。在基线和 12 周时,进行了 24 小时脉搏波速度和血压测量。使用 SphygmoCor 测量的主要结局变量颈股脉搏波速度无显著变化。使用 Mobil-O-Graph,组间诊室脉搏波速度的变化具有显著意义:0.3m/s;95%置信区间,0.1-0.6;p=0.02。接受持续气道正压通气治疗的组脉搏波速度下降幅度大于对照组,但组内变化均无显著意义。12 周后,两组的动态血压均无显著变化。结论:持续气道正压通气治疗 12 周不能显著降低 2 型糖尿病合并阻塞性睡眠呼吸暂停患者的脉搏波速度或血压。