The Effects of Long-term CPAP on Weight Change in Patients With Comorbid OSA and Cardiovascular Disease: Data From the SAVE Trial

Chest: The Journal of Circulation, Respiration and Related Systems

Baixin Chen^1¹  Michael Hlavac^7²  Qian Wang^1³  Craig S. Anderson^12,13⁴  Kelly A. Loffler^2⁵  Yuanming Luo^3⁶  Xilong Zhang^4⁷  Rui Chen^5⁸  Olga Mediano^9,10⁹  Nigel McArdle^8^1,10  Qiong Ou^1^1,11  Ferran Barbe^10,11^1,12  Sutapa Mukherjee^8^1,13  Geraldo Lorenzi-Filho^6^1,14  Luciano F. Drager^6^1,15 

[1] Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia^2;Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain^10;Christchurch Hospital, Christchurch, New Zealand^7;Flinders Centre for Epidemiology and Biostatistics (Dr Woodman), College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia^15;Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangzhou, Guangdong, China^3;Hospital of Nanjing Medical University, Nanjing, Jiangsu, China^4;Hospital of Soochow University, Suzhou, Jiangsu, China^5;Instituto do Coracao and Hospital Universitario, Faculty of Medicine, University of São Paulo, São Paulo, Brazil^6;Neurology Department, Royal Prince Alfred Hospital, Sydney Health Partners, Sydney, NSW, Australia^13;Respiratory Department, Institut de Recerca Biomedica de Lleida, Lleida, Spain^11;Sleep Center, Respiratory and Critical Medical Department, Guangdong Geriatric Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China^1;Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Bedford Park, SA, Australia^14;The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia^12;University Hospital of Guadalajara, Guadalajara, Spain^9;West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia^8

关键词: CPAP;    long-term;    OSA;    weight;    AHI;    apnea-hypopnea index;    CV;    cardiovascular;    ESS;    Epworth Sleepiness Scale;    ODI;    oxygen desaturation index;   

DOI  :  10.1016/j.chest.2018.08.1082

学科分类：呼吸医学

来源: American College of Chest Physicians

【 摘 要 】

Background Although recent evidence suggests that OSA treatment may cause weight gain, the long-term effects of CPAP on weight are not well established. Methods This study was a post hoc analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) study, a multicenter, randomized trial of CPAP plus standard care vs standard care alone in adults with a history of cardiac or cerebrovascular events and moderate to severe OSA. Participants with weight, BMI, and neck and waist circumferences measured at baseline and during follow-up were included. Linear mixed models were used to examine sex-specific temporal differences, and a sensitivity analysis compared high CPAP adherers (≥ 4 h per night) with propensity-matched control participants. Results A total of 2,483 adults (1,248 in the CPAP group and 1,235 in the control group) were included (mean 6.1 ± 1.5 measures of weight available). After a mean follow-up of 3.78 years, there was no difference in weight change between the CPAP and control groups, for male subjects (mean [95% CI] between-group difference, 0.07 kg [–0.40 to 0.54]; P = .773) or female subjects (mean [95% CI] between-group difference, –0.14 kg [–0.37 to 0.09]; P = .233). Similarly, there were no significant differences in BMI or other anthropometric measures. Although male participants who used CPAP ≥ 4 h per night gained slightly more weight than matched male control subjects without CPAP (mean difference, 0.38 kg [95% CI, 0.04 to 0.73]; P = .031), there were no between-group differences in other anthropometric variables, nor were there any differences between female high CPAP adherers and matched control subjects. Conclusions Long-term CPAP use in patients with comorbid OSA and cardiovascular disease does not result in clinically significant weight change. Trial Registry ClinicalTrials.gov; No.: NCT00738179; URL: www.clinicaltrials.gov.

【 授权许可】

CC BY