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Effect of continuous positive airway pressure on endothelin-1 in patients with obstructive sleep apnea: a meta-analysis

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Abstract

Purpose

Obstructive sleep apnea (OSA) is related to endothelin-1 (ET-1). Continuous positive airway pressure (CPAP) is an effective therapy for OSA. However, the effectiveness of CPAP on ET-1 levels in patients with OSA yielded contradictory results. We conducted a meta-analysis to assess the effect of CPAP on ET-1 levels in OSA.

Methods

The Embase, and Cochrane Library and PubMed were searched before March, 2018. The overall effects were measured by the standardized mean difference (SMD) with a 95% confidence interval (CI). Ten studies were included and the meta-analysis was conducted using Stata 14.0.

Results

10 studies involving 375 patients were included in the meta-analysis. The result showed that there was a significant reduction in ET-1 levels in OSA patients before and after CPAP therapy (SMD = − 0.74, 95% CI = − 1.30 to − 0.17, z = 2.56, p = 0.01). Further, subgroup analysis demonstrated that Apnea–Hypopnea Index (AHI), CPAP therapy duration, and sample size also affected CPAP therapy.

Conclusions

Our meta-analysis indicated that CPAP treatment among OSA patients was significantly was related to a decrease in ET-1 levels. Further prospective long-term studies with a larger number of patients are needed to evaluate and clarify this issue.

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Funding

This work was supported by Grant 81370182 from the Chinese National Natural Science Foundation. The sponsor had no role in the design or conduct of this research.

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Author notes

  1. Guofu Lin and Qingshi Chen contributed to the work equally.

Authors and Affiliations

  1. Department of Respiratory Medicine, Fujian Provincial, Fuzhou, People’s Republic of China

    Guofu Lin, Qingshi Chen, Jiefeng Huang, Lida Chen, Ting Lin & Qichang Lin

  2. Sleep-disordered Breathing Clinic Center, Laboratory of Respiratory Disease, Fuzhou, People’s Republic of China

    Guofu Lin, Qingshi Chen, Jiefeng Huang, Lida Chen, Ting Lin & Qichang Lin

  3. The First Affiliated Hospital of Fujian Medical University, NO 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian, People’s Republic of China

    Guofu Lin, Qingshi Chen, Jiefeng Huang, Lida Chen, Ting Lin & Qichang Lin

  4. The Second Affiliated Hospital of Fujian Medical University, Quanzhou, People’s Republic of China

    Qingshi Chen

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  1. Guofu Lin
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All authors directly participated in the study and have reviewed and approved the final manuscript.

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Correspondence to Qichang Lin.

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Lin, G., Chen, Q., Huang, J. et al. Effect of continuous positive airway pressure on endothelin-1 in patients with obstructive sleep apnea: a meta-analysis. Eur Arch Otorhinolaryngol 276, 623–630 (2019). https://doi.org/10.1007/s00405-018-5225-8

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  • DOI: https://doi.org/10.1007/s00405-018-5225-8

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