Cardiometabolic changes after continuous positive airway pressure for obstructive sleep apnoea: a randomised sham-controlled study

Rationale and objectives Impaired insulin sensitivity (ISx), increased visceral abdominal fat (VAF) and liver fat are all central components of the metabolic syndrome and characteristics of men with obstructive sleep apnoea (OSA). The reversibility of these observed changes with continuous positive...

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Published in:	Thorax 2012-12, Vol.67 (12), p.1081-1089
Main Authors:	Hoyos, Camilla M, Killick, Roo, Yee, Brendon J, Phillips, Craig L, Grunstein, Ronald R, Liu, Peter Y
Format:	Article
Language:	eng
Subjects:	Abdominal Fat - metabolism Biological and medical sciences Body Mass Index Cardiology. Vascular system Continuous Positive Airway Pressure Double-Blind Method Fatty Liver - complications Fatty Liver - prevention & control Humans Insulin Resistance Linear Models Male Medical sciences Metabolic Syndrome - complications Metabolic Syndrome - prevention & control Middle Aged Pneumology Polysomnography Respiratory system : syndromes and miscellaneous diseases Risk Factors Sleep Apnea, Obstructive - physiopathology Sleep Apnea, Obstructive - therapy Treatment Outcome
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Summary:	Rationale and objectives Impaired insulin sensitivity (ISx), increased visceral abdominal fat (VAF) and liver fat are all central components of the metabolic syndrome and characteristics of men with obstructive sleep apnoea (OSA). The reversibility of these observed changes with continuous positive airway pressure (CPAP) treatment in men with OSA has not been systematically studied in a randomised sham-controlled fashion. Methods 65 men without diabetes who were CPAP naïve and had moderate to severe OSA (age=49±12 years, apnoea hypopnoea index (AHI)=39.9±17.7 events/h, body mass index=31.3±5.2 kg/m2) were randomised to receive either real (n=34) or sham (n=31) CPAP for 12 weeks. At 12 weeks, all subjects received real CPAP for an additional 12 weeks. Measurements and main results Main outcomes were the change at week 12 from baseline in VAF, ISx and liver fat. Other metabolic outcomes were changes in the disposition index, total fat, and blood leptin and adiponectin concentrations. The AHI was lower on CPAP compared with sham by 33 events/h (95% CI−43.9 to −22.2, p
ISSN:	0040-6376 1468-3296