Dose‐dependent effects of continuous positive airway pressure for sleep apnea on weight or metabolic function: Individual patient‐level clinical trial meta‐analysis
Dose‐dependent effects of continuous positive airway pressure for sleep apnea on weight or metabolic function: Individual patient‐level clinical trial meta‐analysis
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持续气道正压通气治疗睡眠呼吸暂停对体重或代谢功能的剂量依赖性影响：个体患者水平临床试验荟萃分析
DOI：
10.1111/jsr.12788
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发表时间：
2018
影响因子：
4.4
通讯作者：
N. Marshall
中科院分区：
文献类型：
--
作者：
C. Hoyos;S. Murugan;K. Melehan;B. Yee;C. Phillips;Roo Killick;E. Cayanan;Keith Wong;Peter Y. Liu;R. Grunstein;N. Marshall
与安慰剂持续气道正压通气相比，治疗持续气道正压通气似乎增加了体重。目前尚不清楚体重增加是否依赖于治疗持续气道正压通气剂量，或者是否会导致代谢功能障碍。对三项随机安慰剂-持续气道正压通气对照试验（2-3个月）进行数据合成，以检验持续气道正压通气对体重是否存在剂量依赖性效应。还检测了空腹血糖、胰岛素、胰岛素抵抗（稳态模型评估）、脂质和内脏腹部脂肪，以确定对代谢功能的任何影响。使用混合模型方差分析来量化这些影响。分析了128例患者。总体而言，与安慰剂-持续气道正压通气相比，使用治疗-持续气道正压通气的体重略有增加（差异：1.17 kg; 0.37-1.97，p = 0.005），与频繁使用安慰剂-持续气道正压通气相比，频繁使用治疗-持续气道正压通气的患者更大（1.45 kg; 0.10-2.80，p = 0.04）。持续气道正压通气使用作为一个连续变量也与持续气道正压通气使用者的体重变化显著相关（0.30 kg hr−1 night−1; 0.04-0.56，p = 0.001），但与安慰剂使用者的体重变化无关（0.04 kg hr−1 night−1;-0.22至0.26，p = 0.76）。治疗性持续气道正压通气和治疗性持续气道正压通气剂量均未引起代谢结局的任何变化。中期治疗性持续气道正压通气的体重增加效应似乎是适度的，并且不伴有任何不良代谢效应。
Therapeutic‐continuous positive airway pressure seems to increase weight compared with placebo‐continuous positive airway pressure. It is not known whether weight gain with therapeutic‐continuous positive airway pressure dose is dependent or whether it causes metabolic dysfunction. Data synthesis of three randomised placebo‐continuous positive airway pressure‐controlled trials (2–3 months) was performed to test whether there is a dose‐dependent effect of continuous positive airway pressure on weight. Fasting glucose, insulin, insulin resistance (homeostatic model assessment), lipids and visceral abdominal fat were also tested to determine any effect on metabolic function. Mixed‐model analysis of variance was used to quantify these effects. One‐hundred and twenty‐eight patients were analysed. Overall there was a small increase in weight with therapeutic‐continuous positive airway pressure use compared with placebo‐continuous positive airway pressure (difference: 1.17 kg; 0.37–1.97, p = 0.005), which was greater with high‐use therapeutic‐continuous positive airway pressure compared with high‐use placebo‐continuous positive airway pressure (1.45 kg; 0.10–2.80, p = 0.04). Continuous positive airway pressure use as a continuous variable was also significantly associated with weight change in continuous positive airway pressure users (0.30 kg hr−1 night−1; 0.04–0.56, p = 0.001), but not in placebo users (0.04 kg hr−1 night−1; −0.22 to 0.26, p = 0.76). Neither therapeutic‐continuous positive airway pressure nor the dose of therapeutic‐continuous positive airway pressure caused any changes to metabolic outcomes. The weight gain effects of medium‐term therapeutic‐continuous positive airway pressure appear modest and are not accompanied by any adverse metabolic effects.
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影响因子：
5
作者：
Peppard, Paul E.;Young, Terry;Hla, Khin Mae
通讯作者：
Hla, Khin Mae
DOI：
10.1164/rccm.201408-1564oc
发表时间：
2015-07-01
影响因子：
24.7
作者：
Pamidi, Sushmita;Wroblewski, Kristen;Tasali, Esra
通讯作者：
Tasali, Esra
DOI：
10.1056/nejmoa1306187
发表时间：
2014-06-12
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chirinos JA;Gurubhagavatula I;Teff K;Rader DJ;Wadden TA;Townsend R;Foster GD;Maislin G;Saif H;Broderick P;Chittams J;Hanlon AL;Pack AI
通讯作者：
Pack AI
影响因子：
120.7
作者：
Peppard, PE;Young, T;Skatrud, J
通讯作者：
Skatrud, J