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

• Published in: Lung Vol. 187; no. 2; pp. 75 - 81
• Main Authors: Çuhadaroğlu, Çağlar, Utkusavaş, Ayfer, Öztürk, Levent, Salman, Serpil, Ece, Turhan
• Format: Journal Article
• Language: English
• Published: New York New York : Springer-Verlag 01-04-2009; Springer-Verlag; Springer Nature B.V
• 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; Insulin resistance; Sleep apnea; Continuous positive airway pressure; Leptin; Lipid
• ISSN: 0341-2040; 1432-1750
• DOI: 10.1007/s00408-008-9131-5

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). Results In 31 patients who used CPAP for >=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.