The Impact of Continuous Positive Airway Pressure on Circulating IGF-1 in Patients With Obstructive Sleep Apnea.

Abstract

Obstructive sleep apnea (OSA) is a disease with metabolic and cardiovascular consequences and is associated with decreased serum concentrations of insulin-like growth factor-1 (IGF-1). The aim of this study was to investigate whether continuous positive airway pressure (CPAP) will increase serum IGF-1 concentration in patients with OSA. Patients with moderate to severe OSA were recruited from a sleep clinic and serum IGF-1 was measured before initiation of CPAP and at follow-up after 4.8 ± 2.5 months. Patients adherent to CPAP treatment (usage ≥ 4 h/night) were compared with those considered to be nonadherent (usage < 4 h/night). Complete data were obtained from 69 patients (86% male, age 56 ± 12 years, respiratory event index 43 ± 21 events/h, Epworth Sleepiness Scale score 12 ± 5). In those adherent to CPAP (n = 42), there was an increase in serum IGF-1 concentration with 21.1 (95% confidence interval [CI]: 13.1 to 29.2) μg/L compared to 4.7 (95% CI: -4.1 to 13.5) μg/L in the nonadherent group (n = 27) (P = .0083). In a linear multivariate model adjusting for sex, age, body mass index, respiratory event index, and mean oxygen saturation during the night recording, the change in serum IGF-1 concentration was significantly associated with adherence to CPAP treatment (adjusted β coefficient: 21.8, 95% CI: 10.2 to 33.4) and inversely associated with change in body mass index (adjusted β coefficient: -7.1, 95% CI: -11.3 to -3.0) and change in hemoglobin A1c (adjusted β coefficient: -1.8, 95% CI: -33 to -0.3). CPAP usage ≥ 4 h/night is associated with increased serum IGF-1 concentration in male patients with OSA.