Li Mingxia, Lin Hong, Yang Qianru, Zhang Xiaolong, Zhou Qiong, Shi Jiankuan, Ge Fangfang
Xi'an International Medical Center Hospital, Xi'an city, China.
Sleep. 2025 Apr 11;48(4). doi: 10.1093/sleep/zsae280.
Obstructive sleep apnea (OSA) is characterized by disordered breathing during sleep and is associated with major cardiovascular complications. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) as an important treatment for obesity and diabetes mellitus show promising therapeutic prospects in OSA. We conducted a meta-analysis to evaluate the effect of GLP-1RA intervention in OSA individuals.
We searched the PubMed and Web of Science databases (published until July 1, 2024). The included studies evaluated the GLP-1RA in OSA individuals and the efficacy outcomes measured by the apnea-hypopnea index (AHI).
Six studies with a total of 1067 participants enrolled. GLP-1RA significantly decreased AHI with an estimated treatment difference of -9.48 events per hour (95% confidence interval [CI] = -12.56 to - 6.40, I2 = 92%). The change in weight was -10.99 kg and body mass index (BMI) was -1.60 kg/m2. The mean difference in systolic blood pressure was -4.81 mmHg and in diastolic blood pressure was -0.32 mmHg. Tirzepatide significantly reduced AHI more than liraglutide with an estimated treatment difference of -21.86 events per hour (95% CI = -25.93 to -17.79) vs -5.10 events per hour (95% CI = -6.95 to -3.26). Obese individuals experienced a more significant decrease in AHI with an estimated treatment difference of -12.93 events per hour vs -4.31 events per hour. The application of continuous positive airway pressure and the duration of follow-up did not affect the therapeutic effect.
GLP-1RA could significantly reduce the severity of OSA, and also lead to weight loss and lower blood pressure. Further high-quality randomized controlled trials (RCTs) are needed to explore different GLP-1RA treatments and durations in OSA and identify participant subgroups that may benefit the most.
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阻塞性睡眠呼吸暂停（OSA）的特征是睡眠期间呼吸紊乱，并与主要心血管并发症相关。胰高血糖素样肽-1受体激动剂（GLP-1RAs）作为肥胖症和糖尿病的一种重要治疗方法，在OSA中显示出有前景的治疗前景。我们进行了一项荟萃分析，以评估GLP-1RA干预对OSA患者的影响。
我们检索了PubMed和Web of Science数据库（截至2024年7月1日发表的文献）。纳入的研究评估了GLP-1RA对OSA患者的作用，以及通过呼吸暂停低通气指数（AHI）测量的疗效结果。
共纳入6项研究，总计1067名参与者。GLP-1RA显著降低了AHI，估计治疗差异为每小时-9.48次事件（95%置信区间[CI]=-12.56至-6.40，I2=92%）。体重变化为-10.99kg，体重指数（BMI）为-1.60kg/m2。收缩压的平均差异为-4.81mmHg，舒张压的平均差异为-0.32mmHg。替尔泊肽比利拉鲁肽更显著地降低了AHI，估计治疗差异为每小时-21.86次事件（95%CI=-25.93至-17.79），而利拉鲁肽为每小时-5.10次事件（95%CI=-6.95至-3.26）。肥胖个体的AHI下降更为显著，估计治疗差异为每小时-12.93次事件，而其他个体为每小时-4.31次事件。持续气道正压通气的应用和随访时间并未影响治疗效果。
GLP-1RA可显著降低OSA的严重程度，还可导致体重减轻和血压降低。需要进一步开展高质量的随机对照试验（RCT），以探索不同的GLP-1RA治疗方法和治疗时间在OSA中的应用，并确定可能最受益的参与者亚组。
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