Revista Portuguesa de Pneumologia Revista Portuguesa de Pneumologia
Rev Port Pneumol 2017;23:193-202 - Vol. 23 Num.4 DOI: 10.1016/j.rppnen.2017.02.010
Original article
Effects of positive airway pressure therapy on cardiovascular and metabolic markers in males with obstructive sleep apnea
A. Felicianoa,b,, , M.J. Oliveirac, A. Cysneirosa, C. Martinhoa, R.P. Reisb,d, D. Penquee, P. Pintof,g,h, C. Bárbaraa,g,h
a Pneumology in Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
b Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
c Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
d Cardiology Unit, Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
e Proteomics Laboratory, Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
f Sleep and Non Invasive Ventilation Unit, Thorax Department, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
g Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
h Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Received 21 October 2016, Accepted 25 February 2017
Abstract
Introduction

Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular/metabolic complications. Some analytical parameters (homocysteine, glycemic and lipidic profiles) are recognized markers of these consequences. Limited data is available on the association of these markers and OSAS's severity/response to positive airway pressure therapy (PAP).

Material and methods

In this prospective study we analyzed polysomnographic and analytical data of male patients admitted to sleep laboratory. The aim was to evaluate metabolic/cardiovascular markers in snorers and OSAS patients, to relate with sleep parameters and PAP response. One-hundred and three patients were included, and 73 (71%) were OSAS patients. OSAS patients were similar to snorers except for higher body mass index (BMI) and dyslipidemia. Severe OSAS patients showed higher glycemia, HbA1c, insulin, and insulin resistance, and lower HDL cholesterol in comparison to mild–moderate (p<0.05, p<0.05, p<0.001, p<0.001, p<0.05, respectively). Glycemic profile and triglycerides were slightly correlated with OSAS severity. 46 OSAS patients were submitted to 6 months of PAP, with a statistical decrease in mean values of homocysteine, glycemia, total and LDL cholesterol (p<0.05, p<0.05, p<0.05, respectively), and in glycemia and LDL cholesterol in severe group only (p<0.05, p<0.05, respectively).

Results

This study demonstrated an association between glucose metabolism parameters and triglycerides with OSAS severity underlying the complexity of the process leading to cardiovascular/metabolic complications in this disorder. Moreover, homocysteine, glycemic and lipidic profiles changed significantly after 6 months of PAP therapy in OSAS, supporting its cardiovascular and metabolic protective effect.

Conclusion

Our study has reinforced the importance of analytical cardiovascular/metabolic evaluation as complementary tool of diagnosis/treatment response in OSAS.

Keywords
Obstructive sleep apnea, Lipid metabolism, Glucose metabolism, HOMA-IR, Homocysteine, PAP
Rev Port Pneumol 2017;23:193-202 - Vol. 23 Num.4 DOI: 10.1016/j.rppnen.2017.02.010