Browsing by Author "Reis, R.P."
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- Effects of positive airway pressure therapy on cardiovascular and metabolic markers in males with obstructive sleep apneaPublication . Feliciano, A.; Oliveira, M.J.; Cysneiros, A.; Martinho, C.; Reis, R.P.; Penque, D.; Pinto, P.; Bárbara, C.Introduction: Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular/ metabolic complications. Some analytical parameters (homocysteine, glycemic and lipidic profiles) are recognized markers of these consequences. Limited data is available on the association of these markers and OSAS’s severity/response to positive airway pressure therapy (PAP). Material and methods: In this prospective study we analyzed polysomnographic and analytical data of male patients admitted to sleep laboratory. The aim was to evaluate metabolic/cardiovascular markers in snorers and OSAS patients, to relate with sleep parameters and PAP response. One-hundred and three patients were included, and 73 (71%) were OSAS patients. OSAS patients were similar to snorers except for higher body mass index (BMI) and dyslipidemia. Severe OSAS patients showed higher glycemia, HbA1c, insulin, and insulin resistance, and lower HDL cholesterol in comparison to mild---moderate (p < 0.05, p < 0.05, p < 0.001, p < 0.001, p < 0.05, respectively). Glycemic profile and triglycerides were slightly correlated with OSAS severity. 46 OSAS patients were submitted to 6 months of PAP, with a statistical decrease in mean values of homocysteine, glycemia, total and LDL cholesterol(p < 0.05, p < 0.05, p < 0.05, respectively), and in glycemia and LDL cholesterol in severe grouponly (p < 0.05, p < 0.05, respectively).Results: This study demonstrated an association between glucose metabolism parameters andtriglycerides with OSAS severity underlying the complexity of the process leading to cardiovas-cular/metabolic complications in this disorder. Moreover, homocysteine, glycemic and lipidicprofiles changed significantly after 6 months of PAP therapy in OSAS, supporting its cardiovas-cular and metabolic protective effect.Conclusion: Our study has reinforced the importance of analytical cardiovascular/metabolicevaluation as complementary tool of diagnosis/treatment response in OSAS.
- Hematological evaluation in males with obstructive Sleep apnea before and after positive airway pressurePublication . Feliciano, Amelia; Linhas, R.; Marçõa, R.; Cysneiros, A.; Martinho, C.; Reis, R.P.; Penque, Deborah; Pinto, P.; Bárbara, CristinaObstructive sleep apnea syndrome (OSAS) is a systemic inflammatory disease associated with cardiovascular consequences. Red blood cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) are recognized biomarkers of cardiovascular morbidity/mortality. Limited data is available on the association between these parameters and OSAS severity and the relationship with positive airway pressure therapy (PAP). In this prospective study of male OSAS patients we analyzed hematological data in order to evaluate their value in predicting OSAS severity, the relationship with sleep parameters, and their behavior under PAP. Seventy-three patients were included (mean age 46.5 years), of which 36 were mild (49.3%), 10 moderate (13.7%), and 27 severe (37%). The mean RDW increased significantly with OSAS severity and showed a positive correlation with respiratory disturbance index and hypoxemic burdens. Additionally, a group of 48 patients (mean age 47.2 years) were submitted to PAP. After six months, red blood cell count, hemoglobin, hematocrit, and platelet count showed a significant decrease (p < 0.0001; p < 0.0001; p = 0.001; p < 0.0001; respectively). Concerning OSAS severity, these parameters also significantly decreased in mild patients (p = 0.003; p = 0.043; p = 0.020; p = 0.014; respectively) but only hemoglobin, hematocrit, and platelet count decreased in severe cases (p < 0.0001; p = 0.008; p = 0.018; respectively). This study demonstrated an association between RDW values and OSAS severity. Moreover, red cell and platelet parameters changed significantly after PAP, supporting its cardiovascular protective effect. RDW may become a simple/inexpensive blood biomarker, making it useful in prioritizing OSAS patients waiting for polysomnography, and red cell and platelet parameters could be useful in PAP follow up.