1999 Fiscal Year Final Research Report Summary
Changes in coagulation and fibrinogenolysis (factor VII clotting activity and type 1 plasminogen activator inhibitor) in patients with obstructive sleep apnea syndrome following nasal continuous positive airway pressure therapy.
| Project/Area Number |
09670608
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Respiratory organ internal medicine
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| Research Institution | KYOTO UNIVERSITY |
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Principal Investigator |
CHIN Kazuo Kyoto University, Medicine, Lecturer, 医学研究科, 講師 (90197640)
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| Co-Investigator(Kenkyū-buntansha) |
陳 和夫 京都大学, 医学研究科, 講師 (90197640)
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| Project Period (FY) |
1997 – 1999
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| Keywords | obstructive sleep apnea syndrome / obesity / leptin / coagulation / visceral fat nasal / CPAP / factor VII clotting activity / cardiovascular diseases |
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| Research Abstract |
Factor VII clotting activity (FVIIc) which is an independent risk factor for ischemic heart disease, was investigated prospectively in 15 patients with obstructive sleep apnea syndrome (OSAS) before apnea and hypopnea index (AHI) 62±4 (mean±SEM) and after (AHI 3±1) nasal continuous positive airway pressure (nCPAP) treatment for immediate relief, at 1 month after treatment and at over 6 months. FVIIc levels gradually decreased after nCPAP treatment. After 6 months of nCPAP treatment, FVIIc levels had decreased significantly (before 141±12% vs. after 6 months 111±6%;p<0.01). This decrease in FVIIc after long-term nCPAP treatment could improve mortality in OSAS patients.
Visceral fat accumulation (VFA) which is a better predictor of coronary heart disease, and subcutaneous fat accumulation (SFA) were assessed by computed tomography before and after nCPAP treatment in 22 OSAS patients (mean AHI>50). Serum leptin levels of another 21 OSAS patients were measured before and after 3-4 days of nCPAP to gain insight into the mechanism by which nCPAP affects fat distribution. VFA and SFA decreased significantly after 6 months of nCPAP treatment (VFA: from236±16 to 182±14cmィイD12ィエD1, p=0.0003;SFA: from 215±21 to 189±18 cmィイD12ィエD1, p=0.003). The VFA decreased significantly in the body weight reduction (BWR) group (n=9, p<0.01) and No-BWR group (n=13, p<0.03). In contrast, SFA changed significantly in the BWR group only (p<0.01). Leptin levels decreased significantly following 3-4 days of nCPAP (p<0.01), while body weight, fasting insulin or cortisol levels did not change significantly. Correcting of sleep disordered breathing by nCPAP may be used to reduce VFA in OSAS patients. OSAS may have significant effects on the serumleptin levels.
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