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Circulating adipocyte fatty acid–binding protein is reduced by continuous positive airway pressure treatment for obstructive sleep apnea—a randomized controlled study

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

The circulating level of adipocyte fatty acid–binding protein (AFABP), a biomarker with prognostic and therapeutic importance in metabolic disorders, has been shown to be elevated in obstructive sleep apnea (OSA). This randomized controlled study aimed to investigate the effect of continuous positive airway pressure (CPAP) treatment for OSA on AFABP levels.

Methods

Consecutive subjects attending sleep study were invited if they were confirmed to have severe OSA and were free of metabolic diseases. Participants were randomized (1:1) into CPAP or observation group for 4 weeks. Demographics, anthropometric data, and circulating biomarkers were checked at baseline and after the 4-week study period.

Results

Ninety subjects were randomized. The mean age was 46 ± 9 years old; 82% were male. Their mean body mass index (BMI) was 29 ± 5 kg/m2. By intention-to-treat approach, the CPAP group showed significant reductions in Epworth sleepiness scale and morning systolic blood pressure (− 7.2 mmHg, − 12.7 to − 1.7 mmHg, p = 0.011), but no significant difference in AFABP, adiponectin, C-reactive protein (CRP), and 8-isoprostane levels. In the per-protocol analysis, when only those who were compliant to CPAP were included, a significant reduction in AFABP (− 7.32 ng/ml, − 13.58, − 1.06, p = 0.023) were found in the CPAP-treated group compared with the control group, along with improvements in clinical parameters. Changes in AFABP were independently associated with both systolic blood pressure (β = 0.289, p = 0.028) and diastolic blood pressure (β = 0.217, p = 0.030).

Conclusion

CPAP therapy used regularly over 4 weeks for severe OSA lowered circulating AFABP level, suggesting a potential beneficial effect of OSA treatment on alleviating metabolic risks.

Trial registration

The research protocol was registered at the National Institutes of Health clinical trials registry (NCT01173432).

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Acknowledgments

The authors would like to thank Ms. Choi Siu-Ling and all the staff in a sleep laboratory for coordination of investigations, Mr. Kelvin Lau for project coordination and data entry, and Ms. Michelle Cheong for manual scoring of polysomnogram.

Funding

The study was funded by the Research Grants Council of Hong Kong (grant number: 766707). The funding source had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Division of Respiratory and Critical Care Medicine, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam, Hong Kong SAR, China

    Macy M. S. Lui, Judith C. W. Mak, Peony W. C. Chong, David C. L. Lam & Mary S. M. Ip

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  1. Macy M. S. Lui
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  2. Judith C. W. Mak
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  3. Peony W. C. Chong
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  4. David C. L. Lam
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Correspondence to Mary S. M. Ip.

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The authors declare that they have no conflict of interest.

Ethical approval

The research protocol was approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster with HKW IRB reference number: UW07-178 and have been performed in accordance with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Lui, M.M.S., Mak, J.C.W., Chong, P.W.C. et al. Circulating adipocyte fatty acid–binding protein is reduced by continuous positive airway pressure treatment for obstructive sleep apnea—a randomized controlled study. Sleep Breath 24, 817–824 (2020). https://doi.org/10.1007/s11325-019-01893-5

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  • DOI: https://doi.org/10.1007/s11325-019-01893-5

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