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Influence of CPAP therapy on lipid storage, muscle metabolism and insulin action in overweight patients with severe obstructive sleep apnea syndrome

Lookup NU author(s): Professor Mike TrenellORCiD


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Aim: To observe the effect of constant positive airway pressure (CPAP) therapy on regional lipid deposition, muscle metabolism and glucose homeostasis in obese patients with obstructive sleep apnoea syndrome (OSAS). Methods: A total of 29 obese patients underwent assessment before and after a minimum of 12-week CPAP therapy. Abdominal adipose tissue was assessed using magnetic resonance imaging. Intramyocellular lipid (IMCL) and skeletal muscle creatine were assessed using 1H-magnetic resonance spectroscopy. Fasting venous and arterial blood were collected. Glucose control was assessed using the homeostatic model. A subgroup of six patients were also evaluated for skeletal muscle pH, phosphocreatine (PCr) and mitochondrial function using 31P-magnetic resonance spectroscopy. The sample was divided according to CPAP therapy, with regular users defined as a minimum nightly use of ≥4 h; 19 subjects were regular and 10 were irregular CPAP users. Results: Visceral adipose tissue volume and circulating leptin were reduced with regular CPAP use but not with irregular CPAP use. Regular CPAP use also produced an increase in skeletal muscle creatine and resting PCr and a decrease in muscle pH. Neither the regular nor irregular CPAP users showed any change in IMCL content, insulin sensitivity scores or mitochondrial function. Conclusions: These data show that regular CPAP therapy reduces visceral adipose tissue and leptin and improves skeletal muscle metabolites. In obese patients with severe OSAS, regular CPAP use does not improve glucose control, suggesting that the influence of obesity on glucose control dominates over any potential effect of OSAS.

Publication metadata

Author(s): Trenell MI, Ward JA, Yee BY, Phillips C, Kemp GJ, Grunstein RR, Thompson CH

Publication type: Article

Publication status: Published

Journal: Diabetes, Obesity and Metabolism

Year: 2007

Volume: 9

Issue: 5

Pages: 679–687

ISSN (print): 1462-8902

ISSN (electronic): 1463-1326

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/j.1463-1326.2006.00649.x


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