A Randomized Controlled Trial of Continuous Positive Airway Pressure on Glucose Tolerance in Obese Patients with Obstructive Sleep Apnea
Por:
Salord, N, Fortuna, AM, Monasterio, C, Gasa, M, Perez, A, Bonsignore, MR, Vilarrasa, N, Montserrat, JM, Mayos, M
Publicada:
1 ene 2016
Resumen:
Study Objectives: Obstructive sleep apnea (OSA) is associated with an increased prevalence of metabolic syndrome (MetS), even in patients with morbid obesity. Our goal was to address whether continuous positive airway pressure (CPAP) treatment improved glucose metabolism in this population.
Methods: A prospective randomized controlled trial was performed in severe OSA patients with morbid obesity without diabetes in two university referral hospitals. Patients received conservative (CT) versus CPAP treatment for 12 weeks. MetS components, homeostasis model assessment of insulin resistance (HOMA-IR) and oral glucose tolerance were assessed at baseline and after treatment.
Results: A total of 80 patients completed the study (42 CPAP and 38 CT patients). After 12 w of CPAP treatment, weight loss was similar in both groups and physical activity, prevalence of MetS, and HOMA-IR did not change in either group. In the CPAP group impaired glucose tolerance (IGT) reversed in nine patients and IGT developed in none, whereas IGT reversed in five patients and IGT developed in five patients in the CT group (P = 0.039 in the Fisher test). Changes in 2-h plasma glucose after glucose load were greater in the CPAP group than in the CT group (CPAP: -0.5 +/- 1.5 versus CT: 0.33 +/- 1.9, P = 0.007).
Conclusions: The improvement of glucose tolerance in morbidly obese patients with severe obstructive sleep apnea, without changes in homeostasis model assessment of insulin resistance, supports an improvement in peripheral insulin resistance after continuous positive airway pressure treatment.
Filiaciones:
Salord, N:
Hosp Univ Bellvitge, Dept Resp Med, Sleep Unit, Lhospitalet De Llobregat 08907, Spain
Bellvitge Biomed Res Inst IDIBELL, Area Inflammatory Chron & Degenerat Dis, Sect Resp Med, Lhospitalet De Llobregat, Spain
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain
Fortuna, AM:
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain
Hosp Santa Creu & Sant Pau, Dept Resp Med, Sleep Unit, Barcelona, Spain
Monasterio, C:
Hosp Univ Bellvitge, Dept Resp Med, Sleep Unit, Lhospitalet De Llobregat 08907, Spain
Bellvitge Biomed Res Inst IDIBELL, Area Inflammatory Chron & Degenerat Dis, Sect Resp Med, Lhospitalet De Llobregat, Spain
CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain
Gasa, M:
Hosp Univ Bellvitge, Dept Resp Med, Sleep Unit, Lhospitalet De Llobregat 08907, Spain
Bellvitge Biomed Res Inst IDIBELL, Area Inflammatory Chron & Degenerat Dis, Sect Resp Med, Lhospitalet De Llobregat, Spain
Perez, A:
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Dept Endocrinol & Nutr, E-08193 Barcelona, Spain
CIBERDEM, Madrid, Spain
Bonsignore, MR:
Univ Palermo, Biomed Dept Internal & Specialist Med DIBIMIS, I-90133 Palermo, Italy
Vilarrasa, N:
CIBERDEM, Madrid, Spain
Hosp Univ Bellvitge, Dept Endocrinol & Nutr, Lhospitalet De Llobregat 08907, Spain
Montserrat, JM:
CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain
Hosp Clin Barcelona, Dept Resp Med, Sleep Unit, Barcelona, Spain
Mayos, M:
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
CIBER Enfermedades Resp CibeRes CB06 06, Madrid, Spain
Hosp Santa Creu & Sant Pau, Dept Resp Med, Sleep Unit, Barcelona, Spain
Bronze, Green Published
|