• Lung · Mar 2009

    Clinical Trial

    Effects of nasal CPAP treatment on insulin resistance, lipid profile, and plasma leptin in sleep apnea.

    • Cağlar Cuhadaroğlu, Ayfer Utkusavaş, Levent Oztürk, Serpil Salman, and Turhan Ece.
    • Department of Chest Diseases, Istanbul Faculty of Medicine, Istanbul University, Göğüs Hastaliklari Anabilim Dali, Istanbul, Turkey. cuhad@turk.net
    • Lung. 2009 Mar 1; 187 (2): 75-81.

    BackgroundObstructive 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.MethodsIn 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-beta) also were calculated. Thirteen patients were excluded from statistical analyses due to noncompliant CPAP usage (<4 h night(-1)).ResultsIn 31 patients who used CPAP for > or =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.ConclusionsIn 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.

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