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Artículos socios - Artículos
Treatment with continuous positive airway pressure and changes in glucose metabolism and insulin resistance in patients with sleep apnea-hypopnea syndrome
22/11/2016
Vallejo-Vaz A, Muñoz-Hernández R, Medrano-Campillo P, Domínguez M, Caballero C, Sánchez-Armengol M, Villar J, Capote F, Stiefel
J Hypertens 2015;33(e-suppl1):e473.

Abstract

Objective: To assess the effect of continuous positive airway pressure (CPAP) therapy on glucose metabolism and insulin resistance in patients with sleep apnea-hypopnea syndrome (AHS).

 

Design and method: We prospectively included 30 consecutive patients recently diagnosed of AHS with an apnea-hypopnea index of 15 or higher and without prior treatment with CPAP. Patients were evaluated before and after 3-month CPAP therapy. There was no change on drug treatment during the study. Fasting blood glucose (FBG), insulin and HbA1c were measured. Beta-cell function, insulin sensitivity (IS) and insulin resistance index (IR) were estimated using the Homeostasis Model Assessment (HOMA) equations.

 

Results: Mean (SD) age was 51.7 +/- 11.5 years, and mean AHI: 56.3 +/- 25.5. 63.3% were males. 23.3% had type 2 diabetes mellitus and 56.7% hypertension. Body mass index, FBG and HbA1c at baseline were 35.8 +/- 6.5 kg/m2, 108.8 +/- 26.5 mg/dL and 6.1 +/- 0.7%, respectively, and they remained unchanged at the end of follow-up (p = 0,939, p = 0.300 and p = 0.307, respectively). At baseline, AHI correlated with IS (r = -0.45, p = 0.017) and IR (r = 0.43, p = 0.022). 3-month treatment with CPAP significantly decreased insulin levels (microU/ml, baseline: 23.5 +/- 23.9; postCPAP therapy: 16.9 +/- 11.6; p = 0.008) and IR (baseline: 2.5 +/- 1.4; post-CPAP therapy: 2.2 +/- 1,56; p = 0.024). Changes in IS (baseline 54,2 +/- 30,0; postCPAP therapy: 60,0 +/- 26,5; p = 0.055) and beta-cell function (%, baseline 137,8 +/- 70,1; postCPAP therapy: 121,7 +/- 48,9; p = 0.060) tended to be significant.

 

Conclusions: Our results suggest that more severe AHS is related to an impaired IS and higher IR, and that treatment with CPAP may improve the insulin resistance syndrome.

 

Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.


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