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Meta-Analysis
. 2023 Mar 23;18(3):e0282172.
doi: 10.1371/journal.pone.0282172. eCollection 2023.

Efficacy of continuous positive airway pressure on TNF-α in obstructive sleep apnea patients: A meta-analysis

Yong Luo  1 , Fa-Rong Zhang  1 , Jun-Lin Wu  2 , Xi-Jiao Jiang  1
Affiliations
Meta-Analysis

Efficacy of continuous positive airway pressure on TNF-α in obstructive sleep apnea patients: A meta-analysis

Yong Luo et al. PLoS One. .

Abstract

Background: Tumor necrosis factor-α (TNF-α) is an important mediator of the immune response. At present, the improvement of TNF-α after continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) is still controversial.

Methods: We conducted a systematic review of the present evidence based on a meta-analysis to elucidate the effects of TNF-α on OSAHS after CPAP treatment.

Results: To measure TNF-α, ten studies used enzyme-linked immunosorbent assay (ELISA), and one used radioimmunoassay. The forest plot outcome indicated that CPAP therapy would lower the TNF-α levels in OSAHS patients, with a weighted mean difference (WMD) of 1.08 (95% CI: 0.62-1.55; P < 0.001) based on the REM since there is highly significant heterogeneity (I2 = 90%) among the studies. Therefore, we used the subgroup and sensitivity analyses to investigate the source of heterogeneity. The findings of the sensitivity analysis revealed that the pooled WMD ranged from 0.91 (95% CI: 0.52-1.31; P < 0.001) to 1.18 (95% CI: 0.74-1.63; P < 0.001). The findings were not influenced by any single study. Notably, there was homogeneity in the Asia subgroup and publication year: 2019, implying that these subgroups could be the source of heterogeneity.

Conclusion: Our meta-analysis recommends that CPAP therapy will decrease the TNF-α level in OSAHS patients, but more related research should be conducted.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Selection process for studies included in the meta-analysis.
Fig 2
Fig 2. The forest plot outcome indicated that the CPAP therapy will not change the TNF-α level in OSAHS patients.
See this image and copyright information in PMC

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