Francisco Campos-Rodriguez1, Nuria Reyes-Nuñez2, Carlos Queipo-Corona3, Angeles Sanchez-Armengol4, Bernabe Jurado-Gamez5, Jose Cordero-Guevara6, Maria F Troncoso7, Araceli Abad-Fernandez8, Julian Caballero-Rodriguez9, Mercedes Martin-Romero10, Ana Encabo-Motiño11, Lirios Sacristan-Bou12, Javier Navarro-Esteva13, Maria Somoza-Gonzalez14, Juan F Masa15, Maria A Sanchez-Quiroga16, Beatriz Jara-Chinarro17, Belen Orosa-Bertol18, Miguel A Martinez-Garcia19. 1. Respiratory Department, Hospital Universitario de Valme, Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. Electronic address: fracamrod@gmail.com. 2. Respiratory Department, Hospital Universitario de Valme, Sevilla, Spain. 3. Respiratory Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 4. Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocio University Hospital, Sevilla, Spain. 5. Department of Respiratory Medicine, Reina Sofia University Hospital, Institute of Biomedical Research Maimonides (IMIBIC), University of Cordoba, Spain. 6. Unidad de Metodología y Estadística, BioAraba, Vitoria, Spain. 7. Respiratory Department, Fundación Jimenez Diaz, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. 8. Respiratory Department, Hospital Universitario de Getafe, Madrid, Spain. 9. Respiratory Department. Hospital Morales Meseguer, Murcia, Spain. 10. Respiratory Department, Hospital Universitario Virgen de la Victoria, Malaga, Spain. 11. Respiratory Department, Hospital Severo Ochoa, Madrid, Spain. 12. Respiratory Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain. 13. Respiratory Department, Hospital Dr. Negrin, Gran Canaria, Spain. 14. Respiratory Department, Consorcio Sanitario de Terrassa, Barcelona, Spain. 15. Respiratory Department, Hospital San Pedro de Alcantara, Caceres, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. 16. Respiratory Department, Hospital Virgen del Puerto, Caceres, Spain. 17. Respiratory Department, Hospital Puerta de Hierro, Madrid, Spain. 18. Respiratory Department, Hospital Dr Peset, Valencia, Spain. 19. Respiratory Department, Hospital Universitario y Politecnico La Fe, Valencia, Spain.
Abstract
OBJECTIVES: Although an association between uric acid (UA) levels and obstructive sleep apnea (OSA) has been reported, the effect of continuous positive airway pressure (CPAP) on this measure is yet unclear. We aimed to investigate the effect of CPAP therapy on serum UA levels in patients with OSA. METHODS: We conducted a multicenter, open-label, randomized controlled trial in 307 women diagnosed with moderate-to-severe OSA (apnea-hypopnea index [AHI]≥15) in 19 Spanish Sleep Units. Women were randomized to CPAP (n=151) or conservative treatment (n=156) for 12 weeks. Changes in serum UA measures were assessed on an intention-to-treat basis. Additional analyses were conducted in the subgroup of women with CPAP adherence ≥4h/night and those with UA levels ≥6mg/dl. RESULTS:Women had a mean (SD) age of 57.1 (10.1) years, median (first-third quartile) body mass index of 33.7 (29.0-38.5) mg/kg2 and AHI of 32.0 (22.6-48.5). The average serum UA measure was 5.11 (1.26) mg/dl, and 80 (26.1%) participants had UA≥6mg/dl. Compared with the control group, the CPAP group did not achieve any reduction in UA levels (non-adjusted intergroup difference -0.03mg/dl, 95%CI -0.20 to 0.13; p=0.702) after 12 weeks of follow-up. These results did not change when the analysis was restricted to women with CPAP adherence ≥4h/night, or the subgroup of women with hyperuricemia. CONCLUSIONS: Twelve weeks of CPAP therapy does not reduce UA levels compared to conservative treatment in women with moderate-to-severe OSA.
RCT Entities:
OBJECTIVES: Although an association between uric acid (UA) levels and obstructive sleep apnea (OSA) has been reported, the effect of continuous positive airway pressure (CPAP) on this measure is yet unclear. We aimed to investigate the effect of CPAP therapy on serum UA levels in patients with OSA. METHODS: We conducted a multicenter, open-label, randomized controlled trial in 307 women diagnosed with moderate-to-severe OSA (apnea-hypopnea index [AHI]≥15) in 19 Spanish Sleep Units. Women were randomized to CPAP (n=151) or conservative treatment (n=156) for 12 weeks. Changes in serum UA measures were assessed on an intention-to-treat basis. Additional analyses were conducted in the subgroup of women with CPAP adherence ≥4h/night and those with UA levels ≥6mg/dl. RESULTS:Women had a mean (SD) age of 57.1 (10.1) years, median (first-third quartile) body mass index of 33.7 (29.0-38.5) mg/kg2 and AHI of 32.0 (22.6-48.5). The average serum UA measure was 5.11 (1.26) mg/dl, and 80 (26.1%) participants had UA≥6mg/dl. Compared with the control group, the CPAP group did not achieve any reduction in UA levels (non-adjusted intergroup difference -0.03mg/dl, 95%CI -0.20 to 0.13; p=0.702) after 12 weeks of follow-up. These results did not change when the analysis was restricted to women with CPAP adherence ≥4h/night, or the subgroup of women with hyperuricemia. CONCLUSIONS: Twelve weeks of CPAP therapy does not reduce UA levels compared to conservative treatment in women with moderate-to-severe OSA.