Effects Of CPAP-respiration On Serum Lipids Levels In Patients With Obstructive Sleep Apnea Syndrome:a Systematic Review And Meta-analysis

Background:Obstructive Sleep Apnea Syndrome(OSAS)is a condition of obstruction, apneas and arousals while sleeping. Nowadays it has been suggested that OSAS independently influences metabolism and levels of serum lipids. The main treatment for OSAS is continuous positive airways pressure(CPAP).Objectives:To assess the effects of CPAP on serum lipids levels.Search Strategy:We searched Medicine, Embase and Springer Link, CNKI, Wanfang Data and google scholar search engine(2000.01-2011.12).Selection Criteria:We included randomized and non-randomized trials comparing CPAP with inactive control or placebo CPAP in adults with OSAS.Data Collection And Analysis:To assessed trial quality and extracted data. Parallel and crossover group trials were analyzed separately. A meta-analysis was carried out.Results:14RCTs are included in the meta-analysis。1.The indexes measured before and after CPAP treatment:After the process of reasonable standard CPAP treatment, the levels of TC and LDL decrease significantly, the results are [WMD=0.1968,95%CI(0.0752,0.3184)] and [WMD=0.1847,95%CI(0.0481,0.3213)] respectively; the levels of TG and HDL do not change obviously, the results are Z=0.65(P=0.51),[WMD=0.0375,95%CI(0.0752,0.3184)] and Z=1.28(P=0.20),[WMD=0.0498,95%CI(-0.1263,0.0267)] respectively.2.Results of all indexes in parallel group studies:Compared with the baselines, the levels of TC and LDL decrease significantly after CPAP treatment. The results are [WMD=-0.18,95%CI(-0.37,0.00)] and [WMD=-0.22,95%CI(-0.43,-0.01)] respectively; similarly, compared with the baselines, the levels of TG and HDL do not change obviously. The results are Z=0.05(P=0.96),[WMD=0.00,95%CI(-0.13,0.13)] and Z=1.23(P=0.22),[WMD=0.04,95%CI(-0.03,0.11)] respectively.3. Results of all indexes in cross-over group studies:Compared with the baselines, the levels of TC and TG decrease significantly after CPAP treatment. The results are [WMD=-0.25,95%CI(-0.42,-0.09)] and [WMD=-0.19,95%CI(-0.40,0.03)] respectively; similarly, compared with the baselines, the levels of HDL and LDL do not change obviously. The results are Z=1.01(P=0.31),[WMD=-0.03,95%CI(-0.08,0.03)] and Z=1.10(P=0.27),[WMD=-0.10,95%CI(-0.27,-0.08)]respectively.Conclusion:In the systematic review, as an effective treatment and the first choice pathway for OSAS patients, CPAP can independently decrease TC and LDL levels of OSAS patients and ameliorate the symptoms of dyslipidosis. However, the roles of CPAP played in the metabolism of TG and HDL are not supported in this review. Long-term randomized controlled trails defining changes of TG and HDL after CPAP treatment are needed.