Aksakal Alperen, Kerget Buğra, Özkan Hatice Beyza, Araz Ömer, Yilmazel Uçar Elif, Sağlam Leyla, Laloğlu Esra
Department of Pulmonary Diseases, Atatürk University Faculty of Medicine, Erzurum, Türkiye.
Department of Biochemistry, Atatürk University Faculty of Medicine, Erzurum, Türkiye.
Tuberk Toraks. 2024 Mar;72(1):48-58. doi: 10.5578/tt.202401869.
The gold standard treatment for obstructive sleep apnea syndrome (OSAS) is positive airway pressure therapy (PAP) treatments. PAP treatments reduce complications by reducing apnea and hypopnea attacks by creating airflow at a determined pressure. In our study, we aimed to examine the effect of treatment compliance on kidney and liver functions, apneahypopnea (AHI) index, and lipid profile of patients diagnosed with OSAS and started PAP treatment.
Patients who were admitted to the sleep laboratory of our hospital between September 2022 and September 2023 and started PAP treatment after PSG were included in our study. Patients who were called for follow-up six months after the initiation of PAP treatment were divided into two groups according to their compliance with PAP treatment. Patients who used the device for at least four hours per night and more than 70% at night were grouped as PAP-compliant patients, while the other patients were grouped as non-PAP-compliant patients.
It was observed that uric acid, BUN, triglyceride, total cholesterol, ALT, GGT, ALP, and AHI levels of the patients who started PAP treatment decreased after six months (p= 0.001, 0.006, <0.001, 0.006, 0.01, <0.001, <0.001, <0.001 with). It was observed that HDL cholesterol levels increased (p≤ 0.001). It was observed that the change in uric acid, AHI, total cholesterol, and GGT levels in group 1 (n= 36) patients who were compliant with PAP treatment was statistically higher than in group 2 (n= 30) patients (p< 0.001, <0.03, <0.001, 0.008, respectively).
Uric acid, total cholesterol and GGT are biomarkers that may increase in OSAS due to intermittent hypoxia with the involvement of other systems. Since a decrease in these biomarkers can be observed in the early period depending on treatment compliance, these biomarkers can be used practically in the follow-up of treatment compliance and treatment efficacy.
阻塞性睡眠呼吸暂停综合征（OSAS）的金标准治疗方法是气道正压通气（PAP）治疗。PAP治疗通过在设定压力下产生气流来减少呼吸暂停和低通气发作，从而降低并发症。在我们的研究中，我们旨在探讨治疗依从性对诊断为OSAS并开始PAP治疗的患者的肾功能、肝功能、呼吸暂停低通气（AHI）指数和血脂谱的影响。
纳入2022年9月至2023年9月期间入住我院睡眠实验室并在多导睡眠图（PSG）检查后开始PAP治疗的患者。PAP治疗开始6个月后被召回进行随访的患者，根据其对PAP治疗的依从性分为两组。每晚使用该设备至少4小时且夜间使用时间超过70%的患者被归为PAP依从性患者，而其他患者被归为非PAP依从性患者。
开始PAP治疗的患者在6个月后尿酸、血尿素氮、甘油三酯、总胆固醇、谷丙转氨酶（ALT）、γ-谷氨酰转肽酶（GGT）、碱性磷酸酶（ALP）和AHI水平均下降（p分别为0.001、0.006、<0.001、0.006、0.01、<0.001、<0.001、<0.001）。高密度脂蛋白胆固醇（HDL胆固醇）水平升高（p≤0.001）。观察到，在PAP治疗依从性良好的第1组（n = 36）患者中，尿酸、AHI、总胆固醇和GGT水平的变化在统计学上高于第2组（n = 30）患者（p分别<0.001、<0.03、<0.001、0.008）。
尿酸、总胆固醇和GGT是由于间歇性缺氧并累及其他系统而可能在OSAS中升高的生物标志物。由于根据治疗依从性在早期可以观察到这些生物标志物的下降，因此这些生物标志物可实际用于治疗依从性和治疗效果的随访。
