Effects of Nasal CPAP Treatment on Insulin Resistance, Lipid Profile, and Plasma Leptin in Sleep Apnea

Background Obstructive sleep apnea has been linked with metabolic syndrome characterized by dyslipidemia, dyscoagulation, hypertension, and diabetes mellitus type 2 and their cardiovascular consequences. This study was designed to determine the effects of 8 weeks of therapy with continuous positive...

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Bibliographic Details
Published in:Lung 2009-04, Vol.187 (2), p.75-81
Main Authors: Çuhadaroğlu, Çağlar, Utkusavaş, Ayfer, Öztürk, Levent, Salman, Serpil, Ece, Turhan
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers - blood
Blood Glucose - metabolism
Continuous Positive Airway Pressure
Effects
Female
Humans
Insulin - blood
Insulin Resistance
Leptin - blood
Lipids - blood
Male
Medicine
Medicine & Public Health
Metabolic syndrome
Metabolic Syndrome - blood
Metabolic Syndrome - etiology
Metabolic Syndrome - physiopathology
Metabolic Syndrome - prevention & control
Middle Aged
Patient Compliance
Pneumology/Respiratory System
Respiratory therapy
Severity of Illness Index
Sleep apnea
Sleep Apnea Syndromes - blood
Sleep Apnea Syndromes - complications
Sleep Apnea Syndromes - physiopathology
Sleep Apnea Syndromes - therapy
Time Factors
Treatment Outcome
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Summary:Background Obstructive sleep apnea has been linked with metabolic syndrome characterized by dyslipidemia, dyscoagulation, hypertension, and diabetes mellitus type 2 and their cardiovascular consequences. This study was designed to determine the effects of 8 weeks of therapy with continuous positive airway pressure (CPAP) on insulin resistance, glucose, and lipid profile, and the relationship between leptin and insulin-resistance parameters in patients with moderate-to-severe obstructive sleep apnea. Methods In 44 patients, serum cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, very low-density lipoprotein, leptin, and insulin parameters were measured at baseline and after 8 weeks of CPAP. Insulin resistance index was based on the homeostasis model assessment (HOMA-IR) method. Insulin sensitivity (HOMA-S) and insulin secretion capacity (HOMA-β) also were calculated. Thirteen patients were excluded from statistical analyses due to noncompliant CPAP usage (=4 h night⁻¹, CPAP therapy reduced total cholesterol (P < 0.05), low-density lipoprotein (P < 0.05), and leptin (P < 0.05). Circulating leptin levels showed significant correlation with both HOMA-S and HOMA-IR at baseline and follow-up (P = 0.03 for all). In addition, there was no correlation between HOMA-IR and the severity of sleep apnea, which was shown by apnea-hypopnea index. Conclusions In patients with moderate-to-severe obstructive sleep apnea, compliant CPAP usage may improve insulin secretion capacity, reduce leptin, total cholesterol, and low-density lipoprotein levels. Leptin showed significant relationship with insulin resistance, and this relationship remained after 8 weeks of CPAP therapy.
ISSN:0341-2040
1432-1750
DOI:10.1007/s00408-008-9131-5