背景全球每年发生的所有非传染性疾病造成的死亡,阻塞性睡眠呼吸暂停(OSA)和肥胖与猝死和心血管死亡风险增加相关.代谢综合征及其合并症与OSA有关。代谢综合征的三个基本要素是脂质代谢不当,高血压,和胰岛素抵抗。研究了持续气道正压通气(CPAP)对代谢综合征要素和相关症状的影响,以及CPAP治疗是否有助于逆转该综合征。方法本研究是在那格浦尔三级护理中心进行的前瞻性事后研究,Hingna,印度。包括的病例为中度至重度或更严重的OSA,18岁以上,愿意接受CPAP治疗,没有以前或现在的CPAP治疗。他们白天有过度嗜睡的历史。被排除在研究之外的病例是那些活跃的,持续的呼吸疾病需要治疗,干预,或诊断为血脂异常,糖尿病,或者高血压,过去或现在,或对重要末端器官造成损害的证据.在CPAP治疗开始和结束三个月时评估代谢综合征的成分。研究结果本研究纳入了85例,79人完成了大多数病例是男性,由48个人组成,占队列总数的60.8%。此外,54例,占该组的68.4%,有高血压.参与者的平均年龄为53.95岁±6.84岁。BMI平均值为30.4kg/m2±4.642,腰臀比为0.964±0.056,颈围为40.66cm±3.37。研究人群在Epworth嗜睡量表上得分为12.53±2,616。研究人群呼吸暂停低通气指数/呼吸紊乱指数比值为16.118±4.868,为中度风险评分。经过三个月的CPAP治疗,糖化血红蛋白(HbA1c)有显著改善,四碘甲状腺原氨酸(T4),高密度脂蛋白(HDL),和氧气去饱和,它们也具有统计学意义。在研究小组中,收缩压和舒张压分别为2.21mmHg和0.26mmHg,分别。其他指标,包括HbA1c,空腹和餐后血糖,甘油三酯,和高密度脂蛋白胆固醇,显着降低。我们观察到小于50岁年龄组的收缩压改善为0.49mmHg,舒张压改善0.32mmHg,空腹血糖改善14.59mg/dl,在50岁以上的年龄组中,餐后血糖改善更好,达到9.7毫克/分升,随着甘油三酯的统计学显着变化,改善了16.26mg/dl,P值小于0.05。解释CPAP治疗三个月后,HbA1c有显著改善,T4,HDL,和氧气去饱和,它们也具有统计学意义。14例(17.72%)CPAP后治疗不再符合该综合征的要求。血压的舒张压和收缩压值有所改善,空腹和餐后糖水平,HbA1C,和甘油三酯水平。50岁以上的患者在餐后和甘油三酯水平方面表现出更好的改善。女性改善血压和甘油三酯,而男性对血糖水平的反应更好。
Background Of all fatalities occurring globally each year caused by noncommunicable diseases, obstructive sleep apnea (OSA) and obesity are associated with an increased risk of sudden death and cardiovascular mortality. Metabolic syndrome and its comorbidities are linked to OSA. The three essential elements of the metabolic syndrome are improper lipid metabolism, hypertension, and insulin resistance. The effect of continuous positive airway pressure (CPAP) on metabolic syndrome elements and related symptoms and whether CPAP therapy helps reverse the syndrome was studied. Methods The present study is prospective pre-post research conducted at a tertiary care center in Nagpur, Hingna, India. The cases included were of moderate to severe or worse OSA, older than 18 years, willing for CPAP therapy with no previous or current CPAP therapy. They had a history of excessive drowsiness during the day. The cases excluded from the study were those with an active, persistent breathing ailment requiring treatment, intervention, or diagnosis of dyslipidemia, diabetes mellitus, or hypertension, past or present, or evidence of damage to the vital end organs. Components of the metabolic syndrome were assessed at the beginning and end of three months of CPAP therapy. Findings Eighty-five cases were enrolled in the study, of which 79 completed it. The majority of cases were male, comprising 48 individuals, accounting for 60.8% of the total cohort. Additionally, 54 cases, representing 68.4% of the group, had hypertension. The average age of the participants was 53.95 years ± 6.84 years. The BMI mean was 30.4 kg/m2 ± 4.642, with a waist-hip ratio of 0.964 ± 0.056 and a neck circumference of 40.66 cm ± 3.37. The study population scored 12.53 ± 2,616 on the Epworth Sleepiness Scale. The study population\'s apnea-hypopnea index/respiratory disturbance index ratio was 16.118 ± 4.868, a moderate risk score. After three months of CPAP therapy, there was a significant improvement in glycated hemoglobin (HbA1c), tetraiodothyronine (T4), high-density lipoprotein (HDL), and oxygen desaturation, and they were also statistically significant. In the study group, there was a decrease in systolic and diastolic blood pressure of 2.21 mm Hg and 0.26 mm Hg, respectively. Other indicators, including HbA1c, fasting and post-meal blood sugar, triglycerides, and HDL cholesterol, were significantly lower. We observed in the less than 50-year-old age group better improvement in systolic blood pressure of 0.49 mm Hg, diastolic blood pressure improvement of 0.32 mm Hg, and fasting blood sugar improvement of 14.59 mg/dl, and in the age group of more than 50, better improvements in post-meal blood sugar of 9.7 mg/dl, along with a statistically significant change in triglyceride with an improvement of 16.26 mg/dl, P value less than 0.05. Interpretation After three months of CPAP therapy, there was a significant improvement in HbA1c, T4, HDL, and oxygen desaturation, and they were also statistically significant. Fourteen (17.72%) cases of post-CPAP therapy no longer met the requirements for the syndrome. There was an improvement in the blood pressure\'s diastolic and systolic values, fasting and post-prandial sugar levels, HbA1C, and triglyceride levels. Patients over 50 years old showed better improvement in post-meal and triglyceride levels. Females improved blood pressure and triglycerides, whereas males responded better to blood sugar levels.