CPAP对能量消耗,摄入量,荷尔蒙调节和身体组成的影响:随机试验
Pei-Lin Lee1,2,3,4,5, Meng-Yueh Chien6, Shang-Ru Lai7
1Center of Sleep Disorder.
Sleep
|August 28, 2025
概括
阻塞性睡眠呼吸暂停 (OSA) 的持续正气压 (CPAP) 可以导致体重增加,主要是由于增加无脂肪质量 (FFM),而不会显著改变能量消耗或摄入量. 这表明微妙的正能量平衡可能与不良代谢影响无关.
科学领域:
- 睡眠医学
- 代谢研究
- 心血管生理学
背景情况:
- 阻塞性呼吸暂停 (OSA) 是一种常见的疾病,通常用持续正气压 (CPAP) 治疗.
- 在OSA患者开始使用CPAP后,体重增加是常见的现象.
- 与CPAP相关的体重增加的潜在机制和临床相关性仍然不完全理解.
研究的目的:
- 研究CPAP治疗对OSA患者的能量消耗,饮食摄入量,身体组成,身体活动和食欲调节激素的影响.
- 阐明在OSA治疗期间观察到的体重增加的机制.
- 确定CPAP诱导的体重变化是否与不良代谢变化有关.
主要方法:
- 一项涉及OSA患者的开放性随机对照试验,将12周的CPAP治疗与非活跃对照组进行比较.
- 主要结果是休息能量消耗 (REE);次要结果包括热量摄入量,脂肪质量 (FM),无脂肪质量 (FFM) 和体力活动.
- 三级结局评估了食欲调节激素的变化. 分析采用了治疗意图 (ITT) 和每项方案的方法.
主要成果:
- CPAP治疗没有显著影响休息能量消耗 (REE) 或总热量摄入.
- 在CPAP组中观察到晚上体重和体重指数的显著增加.
- CPAP治疗导致无脂肪质量 (FFM),酸格林和类似胰岛素的生长因子1增加,同时降低皮质醇和认知抑制.
结论:
- 在OSA患者中,CPAP诱导的体重增加似乎主要是由无脂肪质量 (FFM) 的增加引起的,而不是脂肪质量.
- 体重增加发生在休息能量消耗,体力活动或热量摄入量没有显著变化的情况下,这表明微妙的正能量平衡.
- 评估CPAP的代谢影响时,应考虑身体组成的变化 (例如,FFM),而不是仅仅关注总体重,因为观察到的增加可能不表明代谢后果.
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