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Weight and metabolic effects of cpap in obstructive sleep apnea patients with obesity

DOI: 10.1186/1465-9921-12-80

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Abstract:

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.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.Weight change rather than elimination of hypoxia modulated alterations in IR in obese patients with OSA during the first six months of CPAP therapy.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 resistance [2]. Obesity is a strong risk factor for OSA [3] and both obesity and OSA are associated with increased insulin resistance and diabetes [4].Hormones involved in the regulation of body weight and glucose metabolism include ghrelin, leptin, adiponectin and resistin. Ghrelin is an orexigenic hormone and it has been proposed as a cause of increased appetite and obesity [5]. Administration of ghrelin increases adiposity, food intake and body weight [6]. It also regulates glucose homeostasis increasing glucose levels and decreasing insulin secretion [7]. Leptin is a hormone secreted by adipocytes in proportion to fat mass. It is elevated in obesity and its administration suppresses appetite and

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