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- Basoglu, Ozen K, et al.
(författare)
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Change in weight and central obesity by positive airway pressure treatment in obstructive sleep apnea patients: longitudinal data from the ESADA cohort.
- 2018
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Ingår i: Journal of sleep research. - : Wiley. - 1365-2869 .- 0962-1105. ; 27:6
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Tidskriftsartikel (refereegranskat)abstract
- The effect of positive airway pressure treatment on weight and markers of central obesity in patients with obstructive sleep apnea remains unclear. We studied the change in body weight and anthropometric measures following positive airway pressure treatment in a large clinical cohort. Patients with obstructive sleep apnea with positive airway pressure treatment from the European Sleep Apnea Database registry (n=1,415, 77% male, age 54±11 [mean±SD] years, body mass index 31.7±6.4kg/m2 , apnea-hypopnea index 37±24n per hr, Epworth Sleepiness Scale 10.2±5.0) were selected. Changes in body mass index and neck/waist/hip circumferences at baseline and at follow-up visit were analysed. Overall, body mass index (0.0 [95% confidence interval, -0.1 to 0.2]kg/m2 ) and neck circumference (0.0 (95% confidence interval, -0.1 to 0.1]cm) were unchanged after positive airway pressure treatment compared with baseline (follow-up duration 1.1±1.0years and compliance 5.2±2.1hr per day). However, in non-obese (body mass index <30kg/m2 ) patients, positive airway pressure treatment was associated with an increased body mass index and waist circumference (0.4 [0.3-0.5]kg/m2 and 0.8 [0.4-1.2]cm, respectively, all p<0.05), and weight gain was significantly associated with higher positive airway pressure compliance and longer positive airway pressure treatment duration. In the obese subgroup, body mass index was reduced after positive airway pressure treatment (-0.3 [-0.5 to -0.1]kg/m2 , p<0.05) mainly in patients with a strong reduction in Epworth Sleepiness Scale. In conclusion, positive airway pressure therapy was not found to systematically change body mass index in the European Sleep Apnea Database cohort, but the response was heterogeneous. Our findings suggest that weight gain may be restricted to an obstructive sleep apnea phenotype without established obesity. Lifestyle intervention needs to be considered in both lean and obese patients with obstructive sleep apnea receiving positive airway pressure treatment.
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| 2. |
- Gündüz, Canan, et al.
(författare)
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Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database.
- 2018
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Ingår i: Respirology (Carlton, Vic.). - : Wiley. - 1440-1843 .- 1323-7799. ; 23:12, s. 1180-1189
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Tidskriftsartikel (refereegranskat)abstract
- Obstructive sleep apnoea (OSA) and dyslipidaemia are independent risk factors for cardiovascular disease. This study investigates the association between OSA and plasma lipid concentrations in patients enrolled in the European Sleep Apnea Database (ESADA) cohort.The cross-sectional analysis included 8592 patients without physician-diagnosed hyperlipidaemia or reported intake of a lipid-lowering drug (age 50.1±12.7years, 69.1% male, BMI: 30.8±6.6kg/m2 , mean apnoea-hypopnoea index (AHI): 25.7±25.9 events/h). The independent relationship between measures of OSA (AHI, oxygen desaturation index (ODI), mean and lowest oxygen saturation) and lipid profile (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and fasting triglycerides (TG)) was determined by means of general linear model analysis.There was a dose response relationship between TC and ODI (mean±SE (mg/dL): 180.33±2.46, 184.59±2.42, 185.44±2.42 and 185.73±2.44; P <0.001 across ODI quartiles I-IV). TG and LDL concentrations were better predicted by AHI than by ODI. HDL-C was significantly reduced in the highest AHI quartile (mean±SE (mg/dL): 48.8±1.49 vs 46.50±1.48; P =0.002, AHI quartile I vs IV). Morbid obesity was associated with lower TC and higher HDL-C values. Lipid status was influenced by geographical location with the highest TC concentration recorded in Northern Europe.OSA severity was independently associated with cholesterol and TG concentrations.
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