Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Str., 17671, Athens, Greece.
Center of Sleep Disorders, 1st Department of Critical Care and Pulmonary Services, Evangelismos Hospital, Medical School of Athens University, 45-47 Ipsilantou Str., 10676, Athens, Greece.
Eur J Nutr. 2021 Oct;60(7):3799-3810. doi: 10.1007/s00394-021-02552-w. Epub 2021 Apr 10.
Inflammation and oxidative stress are implicated in obstructive sleep apnea (OSA) pathophysiology. We aimed at exploring whether the combination of a weight-loss Mediterranean diet/lifestyle intervention with OSA standard care, i.e., continuous positive airway pressure (CPAP) prescription, can lead to greater improvements in inflammation and oxidative stress, compared to standard care alone.
This was a randomized controlled clinical trial in 187 adult, overweight patients with moderate-to-severe OSA. Participants were randomized to a standard care (SCG, n = 65), a Mediterranean diet (MDG, n = 62) or a Mediterranean lifestyle group (MLG, n = 60). All groups received OSA standard care. Intervention arms participated in a 6-month behavioral weight-loss intervention based on the Mediterranean diet, while the MLG also received counselling on physical activity and sleep habits.
Seven patients were excluded and 53/180 were lost to follow-up. In intention to treat analysis (n = 180), the SCG did not exhibit changes in any of the markers assessed. Post-intervention age-, sex-, baseline- and CPAP use-adjusted plasma high sensitivity C-reactive protein levels (mg/L) were lower in the MDG and the MLG compared to the SCG (mean difference - 1.33, P = 0.039 and - 1.68, P = 0.007, respectively). The MLG also exhibited lower urinary 8-iso prostaglandin F2a levels (ng/mg creatinine) compared to the SCG and the MDG (mean difference - 1.10, P < 0.0001 and - 0.80, P = 0.001, respectively). Adiponectin and oxidized guanine levels were not altered in any of the study groups. Results were similar in per protocol analysis (n = 127).
A weight-loss Mediterranean diet/lifestyle intervention on top of CPAP has anti-inflammatory and antioxidant benefits in OSA.
The trial was prospectively registered at ClinicalTrials.gov (NCT02515357) on August 4, 2015.
炎症和氧化应激与阻塞性睡眠呼吸暂停（OSA）的病理生理学有关。我们旨在探索与单独接受标准护理（即持续气道正压通气（CPAP）处方）相比，结合减肥地中海饮食/生活方式干预措施与 OSA 标准护理，是否能在炎症和氧化应激方面带来更大的改善。
这是一项针对 187 名成年超重中重度 OSA 患者的随机对照临床试验。参与者被随机分为标准护理组（SCG，n=65）、地中海饮食组（MDG，n=62）或地中海生活方式组（MLG，n=60）。所有组均接受 OSA 标准护理。干预组参加了为期 6 个月的基于地中海饮食的行为减肥干预，而 MLG 还接受了关于体育活动和睡眠习惯的咨询。
7 名患者被排除，180 名中有 53 名失访。在意向治疗分析（n=180）中，SCG 没有任何评估指标发生变化。与 SCG 相比，MDG 和 MLG 的介入后经年龄、性别、基线和 CPAP 使用调整的血浆高敏 C 反应蛋白水平（mg/L）降低（平均差异-1.33，P=0.039 和-1.68，P=0.007）。MLG 的尿液 8-异前列腺素 F2a 水平（ng/mg 肌酐）也低于 SCG 和 MDG（平均差异-1.10，P<0.0001 和-0.80，P=0.001）。任何研究组的脂联素和氧化鸟嘌呤水平均未改变。在方案分析（n=127）中也得到了类似的结果。
CPAP 联合减肥地中海饮食/生活方式干预对 OSA 具有抗炎和抗氧化作用。
该试验于 2015 年 8 月 4 日在 ClinicalTrials.gov（NCT02515357）进行了前瞻性注册。
