Obstructive sleep apnea, CPAP use might not have an effect on weight, glycemic ends in weight problems

December 01, 2021

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Kobuch does not disclose any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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The presence of obstructive sleep apnea or CPAP use had no effect on weight or glycemic results after 2 months in adults with grade 3 obesity, according to a new study published in Endocrine Disorders.

“Obesity can the pathogenesis of OSA in a number of ways, including upper airway fat deposition and muscle impairment, abdominal fat pressure, leptin resistance, and increased inflammation,” Sophie Kobuch, MD, student at the Western Sydney University School of Medicine in Campbelltown, New South Wales, Australia and colleagues wrote. “Significant weight loss can also reduce symptoms of OSA, but long-term weight loss sufficient to reduce the severity of OSA in those with Class 3 obesity is difficult to achieve and maintain, especially without bariatric surgery.”

The data were from Kobuch S, et al. Endocr Disorder. 2021; doi: 10.1186 / s12902-021-00887-3.

The single-center, retrospective cohort study included 178 patients who initiated an intensive multidisciplinary publicly funded weight management program in Sydney from March 2018 to 2019. The diagnosis of OSA was made through overnight laboratory sleep studies, and CPAP use was confirmed when patients used CPAP an average of 4 hours or more per night. The researchers collected demographics, clinical data, and CPAP use at baseline and after 12 months.

62% of patients completed 12 months of the multidisciplinary weight management program. Of these, 70 (63.1%) patients had OSA, of which 38 patients (54.3%) reported using CPAP. The researchers observed no significant difference in BMI at baseline between those with OSA and CPAP use, those with OSA and no CPAP use, and those without OSA (52.1 kg / m2 and 50.3 kg / m2 vs. 50 , 4 kg / m2); P = .636); however, there were more women among those without OSA (57.9% and 63.5% vs. 90.2%; P = 0.003).

After 12 months, significant weight loss was observed in all three groups, but there was no significant difference in the percentage weight loss in patients with OSA and CPAP use (6.3%), patients with OSA and without CPAP use (6.8 %) and patients without OSA (7.2%). There was also no significant difference in the proportion of patients achieving 5% or more weight loss between those with OSA and CPAP use (57.9%), OSA and no CPAP use (59.4%) and without OSA (65.9%).

The researchers also observed a decrease in HbA1c from 7.8% at baseline to 7.3% at 12 months in patients with type 2 diabetes (P = 0.03). There was no difference in HbA1c reduction between the three groups (P = 0.997).

“The results of this study suggest that the focus should continue to be on the implementation of lifestyle changes and medical weight management in people with grade 3 obesity, regardless of OSA status,” the researchers write.

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