Effects of CPAP on Metabolic Syndrome in Patients With OSA

Giampá, Sara Quaglia de Campos; Furlan, Sofia F.; Freitas, Lunara S.; Macedo, Thiago Andrade; Lebkuchen, Adriana; Cardozo, Karina Helena Morais; Carvalho, Valdemir Melechco; Martins, Franco Chies; Azam, I.F.B.; Costa-Hong, Valéria; Lopes, Heno Ferreira; Baptista, Mariana Lins; Rochitte, Carlos Eduardo; Bortolotto, Luiz Aparecido; Lorenzi‐Filho, Geraldo; Drager, Luciano F.

doi:10.1016/j.chest.2021.12.669

Cited by 27 publications

(22 citation statements)

References 45 publications

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“…Numerous studies have shown that CPAP, by reducing or abolishing nocturnal hypoxic episodes, results in the improvement of hemodynamic (ie, blood pressure, arterial stiffness), hormonal (ie, catecholamines) and cardio‐metabolic (ie, metabolic syndrome) parameter, thus favorably influencing the cardiovascular prognosis in this setting 11,12 …”

Section: Introductionmentioning

confidence: 99%

The impact of continuous positive airway pressure on cardiac mechanics: Findings from a meta‐analysis of echocardiographic studies

Tadić

Gherbesi

Faggiano

et al. 2022

J of Clinical Hypertension

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Current evidence on the effects of continuous positive airway pressure (CPAP) on cardiac mechanics in patients with obstructive sleep apnea (OSA) is based on a few single studies. The authors investigated this topic through a meta-analysis of speckle tracking echocardiography (STE) studies that provided data on left ventricular (LV) and right ventricular (RV) mechanics as assessed by global longitudinal strain (GLS).The PubMed, OVID-MEDLINE, and Cochrane library databases were systematically analyzed to search English-language review papers published from inception to January 31, 2022. Studies were identified by crossing the following terms: "obstructive sleep apnea", "sleep quality", "sleep disordered breathing", "continuous positive airway pressure therapy", "noninvasive ventilation", "left ventricular hypertrophy", "systolic dysfunction", "global longitudinal strain", "left ventricular mechanics", "right ventricular mechanics", "echocardiography" and "STE echocardiography". The meta-analysis, including a total of 337 patients with OSA from nine studies (follow-up 2-24 months) showed a significant GLS improvement in both LV and RV after CPAP, standard mean difference (SMD) being 0.51±0.08, CI:0.36-0.66, p = .0001 and 0.28±0.07, CI:0.15-0.42, p = .0001), respectively. Corresponding SMD values for LV ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) were 0.20±0.06,

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Section: Introductionmentioning

confidence: 99%

The impact of continuous positive airway pressure on cardiac mechanics: Findings from a meta‐analysis of echocardiographic studies

Tadić

Gherbesi

Faggiano

et al. 2022

J of Clinical Hypertension

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“…A large clinical data shows that metabolic alterations are independent risk factors in the cardiovascular consequences associated with OSA ( Garbarino et al, 2018 ). It has reported that OSA severity correlated with the amount of visceral fat than to body mass index (BMI) ( Giampá et al, 2022 ; Neeland et al, 2020 ). Many studies show that OSA affects the release of adipokines in the adipocyte tissues ( Li et al, 2010 ; Gami et al, 2003 ).…”

Section: Discussionmentioning

confidence: 99%

Potential regulatory role of miRNA and mRNA link to metabolism affected by chronic intermittent hypoxia

Duan

Zhang²,

Liu³

et al. 2022

Front. Genet.

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Aim: Intermittent hypoxia (IH) is the prominent feature of obstructive sleep apnea (OSA) pathophysiology, which is an in dependent risk factor of cardiovascular complications. The effects of IH on adipocyte metabolism were explored by high-throughput sequencing technology.Methods: Plasma was collected from OSA patients and control group to perform mRNA sequencing. 3T3-L1 cells were differentiated into adipocytes then subjected to a 5%–21% O2 hypoxic environment (IH) for 24 h. High-throughput sequencing method was used to determine differential mRNA and miRNA patterns in fat cells exposed to IH. We then performed Gene Ontology (GO) analysis, identified relevant KEGG pathways and miRNA-target-pathways.Results: Sequencing data showed that OSA affected the expression of 343 mRNAs in the plasma. At the same time, we found that IH affected the expression of 3034 mRNAs in the adipocytes. In addition, 68 differentially expressed mRNAs were overlapped in plasma from OSA patient and IH-induced adipocyte model. We observe that 68 differential genes could be connected to 49 reciprocally expressed miRNAs. We showed that IH significantly reduced the expression of miR-182-5p and miR-30c-2-3p. KEGG predicted that the function of expressed miR-182-5p and miR-30c-2-3p was enriched to AKT signaling pathway. Notably, IH activated PI3K/AKT pathway in fat cells.Conclusion: Our results demonstrated that IH might induce adipocyte metabolism by regulating miR-182-5p and miR-30c-2-3p.

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“…Computed tomography has shown an increase in visceral fat in men with OSA, with and without obesity, even after adjusting for age and BMI [71, 72]. OSA treatment with CPAP for 6 months showed a very small decrease in VAT compared with the placebo group, highlighting no relevant effects of OSA in modulating the amount of VAT but the properties of this adipose tissue [42]. To address this very relevant topic, some studies have focused on evaluating the VAT‐specific metabolic or inflammatory activity [25].…”

Section: Perspectives and Research Agendamentioning

confidence: 99%

Obstructive sleep apnea and metabolic syndrome

Giampá

Lorenzi‐Filho

Drager

2023

Obesity

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Metabolic syndrome (MS) is a heterogeneous condition associated with increased cardiovascular risk. There is growing evidence from experimental, translational, and clinical investigations that has suggested that obstructive sleep apnea (OSA) is associated with prevalent and incident components of MS and MS itself. The biological plausibility is supportive, primarily related to one of the main features of OSA, namely intermittent hypoxia: increased sympathetic activation with hemodynamic repercussions, increased hepatic glucose output, insulin resistance through adipose tissue inflammation, pancreatic β-cell dysfunction, hyperlipidemia through the worsening of fasting lipid profiles, and the reduced clearance of triglyceride-rich lipoproteins. Although there are multiple related pathways, the clinical evidence relies mainly on cross-sectional data preventing any causality assumptions. The overlapping presence of visceral obesity or other confounders such as medications challenges the ability to understand the independent contribution of OSA on MS. In this review, we revisit the evidence on how OSA/intermittent hypoxia could mediate adverse effects of MS parameters independent of adiposity. Particular attention is devoted to discussing recent evidence from interventional studies. This review describes the research gaps, the challenges in the field, perspectives, and the need for additional high-quality data from interventional studies addressing the impact of not only established but promising therapies for OSA/obesity.

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Effects of CPAP on Metabolic Syndrome in Patients With OSA

Cited by 27 publications

References 45 publications

The impact of continuous positive airway pressure on cardiac mechanics: Findings from a meta‐analysis of echocardiographic studies

The impact of continuous positive airway pressure on cardiac mechanics: Findings from a meta‐analysis of echocardiographic studies

Potential regulatory role of miRNA and mRNA link to metabolism affected by chronic intermittent hypoxia

Obstructive sleep apnea and metabolic syndrome

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