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Review
. 2021 Apr 2;10(7):1485.
doi: 10.3390/jcm10071485.

Body Mass Index Reduction and Selected Cardiometabolic Risk Factors in Obstructive Sleep Apnea: Meta-Analysis

Marta Stelmach-Mardas  1 , Beata Brajer-Luftmann  2 , Marta Kuśnierczak  3 , Halina Batura-Gabryel  2 , Tomasz Piorunek  2 , Marcin Mardas  3
Affiliations
Review

Body Mass Index Reduction and Selected Cardiometabolic Risk Factors in Obstructive Sleep Apnea: Meta-Analysis

Marta Stelmach-Mardas et al. J Clin Med. .

Abstract

Although clinical studies have been carried out on the effects of weight reduction in sleep apnea patients, no direct link has been shown between weight reduction and changes in cardio-metabolic risk factors. We aimed to analyze changes in the apnea-hypopnea index and selected cardio-metabolic parameters (total cholesterol, triglycerides, glucose, insulin, blood pressure) in relation to the reduction in body mass index in obstructive sleep apnea patients. Medline, Web of Science and Cochrane databases were searched to combine results from individual studies in a single meta-analysis. We identified 333 relevant articles, from which 30 papers were assigned for full-text review, and finally 10 (seven randomized controlled trials and three nonrandomized studies) were included for data analysis. One unit of body mass index reduction was found to significantly influence changes in the apnea-hypopnea index (-2.83/h; 95% CI: -4.24, -1.41), total cholesterol (-0.12 mmol/L; 95% CI: -0.22, -0.01), triglycerides (-0.24 mmol/L; 95% CI: -0.46, -0.02), fasting insulin (-7.3 pmol/L; 95% CI: -11.5, -3.1), systolic (-1.86 mmHg; 95% CI: -3.57, -0.15) and diastolic blood pressure (-2.07 mmHg; 95% CI: -3.79, -0.35). Practical application of lifestyle modification resulting in the reduction of one unit of body mass index gives meaningful changes in selected cardio-metabolic risk factors in obstructive sleep apnea patients.

Keywords: apnea–hypopnea index; biological markers; blood pressure; weight loss.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Process of the literature search for dietary intervention and cardio-metabolic risk factors in adults.
Figure 2
Figure 2
Forest plot for mean apnea–hypopnea index (AHI) change per 1 unit of body mass index (BMI) reduction in selected studies.
Figure 3
Figure 3
Forest plot for mean cardio-metabolic parameters change in subgroup analysis: total cholesterol, triglycerides, glucose, insulin per 1 unit of body mass index (BMI) reduction in selected studies.
Figure 4
Figure 4
Forest plot for mean cardio-metabolic parameter changes in subgroup analysis: systolic and diastolic blood pressure per 1 unit of body mass index (BMI) reduction in selected studies.
Figure 5
Figure 5
Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies.
Figure 6
Figure 6
Funnel plot of standard error by standard differences in means of: (A) apnea–hypopnea index, (B) total cholesterol, triglycerides, glucose and insulin, (C) systolic and diastolic blood pressure in selected studies per unit of body mass index reduction.
See this image and copyright information in PMC

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