Hassan Kahal1,2, Ioannis Kyrou1,2,3,4, Olalekan Uthman5, Anna Brown6, Samantha Johnson7, Peter Wall8, Andrew Metcalfe8, Abd A Tahrani9,10,11, Harpal S Randeva1,2,3,4. 1. Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom. 2. Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom. 3. Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B4 7ET, United Kingdom. 4. Centre of Applied Biological and Exercise Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5FB, United Kingdom. 5. Division of Health Sciences, Warwick - Centre for Applied Health Research and Delivery (WCAHRD), Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom. 6. Library and Knowledge Services, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom. 7. University of Warwick Library, University of Warwick, Coventry CV4 7AL, United Kingdom. 8. Department of Warwick Orthopaedics, Warwick Medical School, University of Warwick, Coventry CV2 2DX, United Kingdom. 9. Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom. 10. Centre of Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham United Kingdom. 11. Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, United Kingdom.
Abstract
Study Objectives: In this systematic review and meta-analysis, we aimed to examine the relationship between obstructive sleep apnea (OSA) and metabolic abnormalities in women with polycystic ovary syndrome (PCOS). Methods: Electronic databases (Medline, Embase, Cinahl, PsycInfo, Scopus, Web of Science, Opengrey, and CENTRAL), conference abstracts, and reference lists of relevant articles were searched. No restriction was applied for language or publication status. Results: Six studies involving 252 participants were included. Women with PCOS and OSA had significantly higher body mass index (mean difference [MD]: 6.01 kg/m2, 95% confidence intervals [CI]: 4.69-7.33), waist circumference (MD: 10.93 cm, 95% CI: 8.03-13.83), insulin resistance, systolic and diastolic blood pressure, and worse lipids' profile and impaired glucose regulation compared with women with PCOS without OSA. Most studies did not adjust for weight in their between-groups analysis. Total and free testosterone levels were not significantly different between the two groups. The majority of studies were found to be at high risk of selection bias, did not account for important confounders, were conducted in one country (United States), and used different methodologies to assess testosterone levels (preventing a meta-analysis for this specific outcome). Conclusions: OSA is associated with obesity and worse metabolic profiles in women with PCOS. However, whether the effects of OSA are independent of obesity remain unclear. As OSA is a treatable condition, research focused on the independent effects of OSA on key clinical outcomes in women with PCOS, including fertility, psychological health, type 2 diabetes, and cardiovascular risk, is lacking and needed. PROSPERO registration number: CRD42016048587.
Study Objectives: In this systematic review and meta-analysis, we aimed to examine the relationship between obstructive sleep apnea (OSA) and metabolic abnormalities in women with polycystic ovary syndrome (PCOS). Methods: Electronic databases (Medline, Embase, Cinahl, PsycInfo, Scopus, Web of Science, Opengrey, and CENTRAL), conference abstracts, and reference lists of relevant articles were searched. No restriction was applied for language or publication status. Results: Six studies involving 252 participants were included. Women with PCOS and OSA had significantly higher body mass index (mean difference [MD]: 6.01 kg/m2, 95% confidence intervals [CI]: 4.69-7.33), waist circumference (MD: 10.93 cm, 95% CI: 8.03-13.83), insulin resistance, systolic and diastolic blood pressure, and worse lipids' profile and impaired glucose regulation compared with women with PCOS without OSA. Most studies did not adjust for weight in their between-groups analysis. Total and free testosterone levels were not significantly different between the two groups. The majority of studies were found to be at high risk of selection bias, did not account for important confounders, were conducted in one country (United States), and used different methodologies to assess testosterone levels (preventing a meta-analysis for this specific outcome). Conclusions: OSA is associated with obesity and worse metabolic profiles in women with PCOS. However, whether the effects of OSA are independent of obesity remain unclear. As OSA is a treatable condition, research focused on the independent effects of OSA on key clinical outcomes in women with PCOS, including fertility, psychological health, type 2 diabetes, and cardiovascular risk, is lacking and needed. PROSPERO registration number: CRD42016048587.
Authors: Balachandran Kumarendran; Dana Sumilo; Michael W O'Reilly; Konstantinos A Toulis; Krishna M Gokhale; Chandrika N Wijeyaratne; Arri Coomarasamy; Wiebke Arlt; Abd A Tahrani; Krishnarajah Nirantharakumar Journal: Eur J Endocrinol Date: 2019-04 Impact factor: 6.664
Authors: Hassan Kahal; Ioannis Kyrou; Olalekan A Uthman; Anna Brown; Samantha Johnson; Peter D H Wall; Andrew Metcalfe; David G Parr; Abd A Tahrani; Harpal S Randeva Journal: Sleep Breath Date: 2019-05-20 Impact factor: 2.816
Authors: Hassan Kahal; Abd A Tahrani; Ioannis Kyrou; Georgios K Dimitriadis; Peter K Kimani; Thomas M Barber; Matthew Nicholls; Asad Ali; Martin O Weickert; Harpal S Randeva Journal: Ther Adv Endocrinol Metab Date: 2020-02-21 Impact factor: 3.565