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

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.