Bardóczi Anna, Matics Zsombor Zoltán, Turan Caner, Szabó Bence, Molnár Zsolt, Hegyi Péter, Müller Veronika, Horváth Gábor
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Pulmonology, Semmelweis University, Budapest, Hungary.
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary.
Sleep Med Rev. 2025 Aug;82:102119. doi: 10.1016/j.smrv.2025.102119. Epub 2025 Jun 17.
The primary etiologic risk factor for obstructive sleep apnea (OSA) is obesity. As incretin-based therapies, specifically glucagon-like peptide 1 (GLP-1) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists, have shown promising outcomes in obesity management, these medications have generated interest in OSA therapy. To investigate their efficacy in OSA, we performed a systematic literature search following PRISMA and Cochrane Handbook guidelines for studies reporting apnea-hypopnea index (AHI) and incretin-based therapy in patients with OSA. Only randomized controlled trials were eligible for inclusion. Our literature search identified 813 publications, and 5 articles met the inclusion criteria. Collectively, the studies enrolled 1024 patients, lasted ≥12 weeks with liraglutide or tirzepatide, and resulted in significant reductions in body weight and/or body mass index. Incretin-based therapies were also associated with AHI reduction, with a mean change of -14.45 events/h (95 % CI: 25.90 to -2.99, p < 0.001). By pooling data of 5 RCTs in a pairwise meta-analysis, incretin-based therapies showed a greater effect on AHI than usual care, with a mean difference of -11.61 events/h (95 % CI: 22.91 to -0.31, p = 0.046). Our analysis demonstrates that weight reduction through incretin-based therapies improves AHI in OSA. Incretin-based therapies have the potential to treat sleep-disordered breathing in OSA patients with excess weight.
阻塞性睡眠呼吸暂停（OSA）的主要病因风险因素是肥胖。由于基于肠促胰岛素的疗法，特别是胰高血糖素样肽1（GLP-1）和双GLP-1/葡萄糖依赖性促胰岛素多肽（GIP）激动剂，在肥胖管理方面已显示出有前景的结果，这些药物引起了对OSA治疗的兴趣。为了研究它们在OSA中的疗效，我们按照PRISMA和Cochrane手册指南进行了系统的文献检索，以查找报告OSA患者呼吸暂停低通气指数（AHI）和基于肠促胰岛素疗法的研究。仅纳入随机对照试验。我们的文献检索共识别出813篇出版物，5篇文章符合纳入标准。总体而言，这些研究共纳入了1024例患者，使用利拉鲁肽或替尔泊肽治疗持续≥12周，体重和/或体重指数显著降低。基于肠促胰岛素的疗法还与AHI降低相关，平均变化为-14.45次/小时（95%CI：-25.90至-2.99，p<0.001）。通过对5项随机对照试验的数据进行成对荟萃分析，基于肠促胰岛素的疗法对AHI的影响大于常规治疗，平均差异为-11.61次/小时（95%CI：-22.91至-0.31，p=0.046）。我们的分析表明，通过基于肠促胰岛素的疗法减轻体重可改善OSA患者的AHI。基于肠促胰岛素的疗法有潜力治疗超重OSA患者的睡眠呼吸障碍。
