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Báo cáo y học: " Weight and metabolic effects of cpap in obstructive sleep apnea patients with obesity"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài:" Weight and metabolic effects of cpap in obstructive sleep apnea patients with obesity. | Garcia et al. Respiratory Research 2011 12 80 http respiratory-research.eom content 12 1 80 RESPIRATORY RESEARCH RESEARCH Open Access Weight and metabolic effects of cpap in obstructive sleep apnea patients with obesity Jose M Garcia1 3 Hossein Sharafkhaneh4 Max Hirshkowitz2 4 Rania Elkhatib4 and Amir Sharafkhaneh2 4 Abstract Background Obstructive sleep apnea OSA is associated with obesity insulin resistance IR and diabetes. Continuous positive airway pressure CPAP rapidly mitigates OSA in obese subjects but its metabolic effects are not well-characterized. We postulated that CPAP will decrease IR ghrelin and resistin and increase adiponectin levels in this setting. Methods In a pre- and post-treatment within-subject design insulin and appetite-regulating hormones were assayed in 20 obese subjects with OSA before and after 6 months of CPAP use. Primary outcome measures included glucose insulin and IR levels. Other measures included ghrelin leptin adiponectin and resistin levels. Body weight change were recorded and used to examine the relationship between glucose regulation and appetite-regulating hormones. Results CPAP effectively improved hypoxia. However subjects had increased insulin and IR. Fasting ghrelin decreased significantly while leptin adiponectin and resistin remained unchanged. Forty percent of patients gained weight significantly. Changes in body weight directly correlated with changes in insulin and IR. Ghrelin changes inversely correlated with changes in IR but did not change as a function of weight. Conclusions Weight change rather than elimination of hypoxia modulated alterations in IR in obese patients with OSA during the first six months of CPAP therapy. Background Obstructive sleep apnea OSA is characterized by sleep-related airway obstructions that produce apnea. These events provoke arousals and cause oxygen desaturations and heightened sympathetic activity during sleep and waking hours 1 that may play a role in the development of insulin .