Dados do Trabalho

Título

Effects of CPAP therapy on the HDL metabolism of patients with metabolic syndrome and obstructive sleep apnea: a substudy of TREATOSA-MS randomized trial

Introdução

There are growing evidence from translational and clinical studies that obstructive sleep apnea (OSA) is associated with chylomicron and triglycerides metabolism impairment that are partially reversed by using continuous positive airway pressure (CPAP). However, the effect of CPAP therapy on high-density lipoprotein (HDL) metabolism is unknown.

Objetivo

To examine the effects of 6 months of CPAP therapy on markers of HDL metabolism of patients with metabolic syndrome (MS) and OSA.

Métodos

The TREATOSA-MS is a randomized placebo-controlled trial that enrolled adult patients with a recent diagnosis of MS (NCEP III criteria) and moderate to severe OSA (apnea-hypopnea index, AHI ≥15 events/h) to undergo 6 months of therapeutic CPAP or nasal dilator strips (placebo group). All patients were non-smokers and used no medications. In this substudy, fasting blood samples collected before and after each intervention were selected for HDL metabolism analysis and plasma lipid determination. Free and esterified cholesterol transfers to HDL were performed by an artificial nanoemulsion to HDL assay. In addition, plasma levels of cholesteryl ester transfer protein (CETP) and the lecithin-cholesterol acyltransferase (LCAT) were determined by enzyme-linked immunosorbent assay.

Resultados

Sixty-three patients were included in this substudy (placebo: n=30; CPAP: n=33). Compared to baseline, 6 months of CPAP treatment had no significant effects on the free (Δ: 0.13±0.59; p=0.553) and esterified cholesterol transfer (Δ: 0.01±0.42; p=0.933). No significant differences in CETP (p=0.26) and LCAT (p=0.68) were observed between the CPAP and placebo groups.

Conclusões

Six months of CPAP therapy did not have significant effects on markers of HDL metabolism in patients with MS and moderate to severe OSA.

Palavras -chave

Cholesterol, HDL; continuous positive airway pressure; lipid metabolism; metabolic syndrome; sleep apnea, obstructive.