A randomised controlled trial of nasal continuous positive airway pressure on insulin sensitivity in obstructive sleep apnoea

European Respiratory Journal - Tập 35 Số 1 - Trang 138-145 - 2010
Jamie C.M. Lam1, B Lam2, Tzy‐Jyun Yao3, Agnes Yuen Kwan Lai2, Clara Ooi4,5, S Tam6, Karen S.L. Lam2,7, Msm Ip2,7
1Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
2Depts of Medicine, " Radiology, Queen Mary Hospital, The University of Hong Kong,
3Medical Statistics Unit, Clinical Trial Centre, The University of Hong Kong,
4Hong Kong SAR, China
5University Dept of Medicine Queen Mary Hospital 102 Pokfulam Road
6Dept of Clinical Biochemistry, Queen Mary Hospital, Hong Kong, SAR, China.
7Research Centre for Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, and

Tóm tắt

The effects of treatment of obstructive sleep apnoea (OSA) on glucose metabolism have been investigated previously with conflicting results. This study evaluated the impact of nasal continuous positive airway pressure (nCPAP) treatment of OSA on insulin sensitivity.Males with moderate/severe OSA and no significant comorbidity were randomised to a therapeutic or sham nCPAP treatment group for 1 week and then reassessed. Those who received therapeutic nCPAP were further evaluated at 12 weeks. Insulin sensitivity (Kitt) was estimated by the short insulin tolerance test. Other evaluations included blood pressure, metabolic profile, urinary catecholamines and intra-abdominal fat.In total, 61 Chinese subjects were randomised. 31 subjects receiving therapeutic nCPAP showed an increase in Kitt(6.6±2.9 to 7.6±3.2 %·min−1; p = 0.017), while the 30 patients on sham CPAP had no significant change, and the changes in Kittwere different between the two groups (p = 0.022). At 12 weeks, improvement in Kittwas seen in 20 subjects with BMI ≥25 kg·m−2(median (interquartile range) 28.3 (26.6–31.5); p = 0.044), but not in the nine subjects with BMI<25 kg·m−2, or the entire group.The findings indicate that therapeutic nCPAP treatment of OSA for 1 week improved insulin sensitivity in nondiabetic males, and the improvement appeared to be maintained after 12 weeks of treatment in those with moderate obesity.

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European Respiratory Journal

Tập 35 Số 1

138-145

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