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The effect of continuous positive airway pressure on circulating malondialdehyde among obstructive sleep apnea patients: a meta-analysis

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Obstructive sleep apnea (OSA) has been demonstrated to be associated with an increase of oxidative stress. However, whether circulating malondialdehyde (MDA), a widely used biomarker of oxidative stress, could be reduced by the treatment of OSA by continuous positive airway pressure (CPAP) is debated. The present meta-analysis was performed to determine the effect of CPAP treatment on circulating MDA among patients with OSA.

Methods

A systematic search of PubMed, Embase, and Web of Science was performed for literature covering the period between 1967 and August 2019. Standardized mean difference (SMD) was calculated to estimate the treatment effects of pre- and post-CPAP therapy.

Results

A total of 10 studies with 220 patients were included in this meta-analysis. A significant decrease in circulating MDA was observed after CPAP treatment (SMD = 1.164, 95% CI = 0.443 to 1.885, z = 3.16, p = 0.002) in OSA patients. Subgroup analyses revealed that CPAP therapy was associated with a significant decrease of circulating MDA in elder (SMD = 1.629, 95% CI = 0.265 to 2.994, z = 2.34, p = 0.019), more obese patients (SMD = 0.954, 95% CI = 0.435 to 1.473, z = 3.61, p = 0.000), more severe OSA patients (SMD = 0.879, 95% CI = 0.421 to 1.336, z = 3.76, p = 0.000), patients with therapeutic duration ≥ 3 months (SMD = 1.867, 95% CI = 0.563 to 3.172, z = 2.80, p = 0.005), and patients with good compliance (SMD = 1.004, 95% CI = 0.703 to 1.305, z = 6.54, p = 0.000).

Conclusions

This meta-analysis suggested that CPAP therapy exerted significant lowering effects on circulating MDA, especially in elder, more obese, and more severe OSA patients and patients with good compliance as well as longer duration of CPAP application.

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Funding

This work was supported by the National Natural Science Foundation of China (81870074 and 81900088) and Startup Fund for scientific research from Fujian Medical University (2017XQ1117).

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Author notes

  1. Qin Chen, Li-Da Chen and Meng-Xue Chen contributed equally to this work.

Authors and Affiliations

  1. College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, People’s Republic of China

    Qin Chen

  2. Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People’s Republic of China

    Li-Da Chen, Hui-Xue Zeng, Miao-Fen Hu, Wei-Liang Zhang & Yi-Feng Zheng

  3. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, No 20, Chazhong road, Taijiang district, Fuzhou, 350005, Fujian Province, People’s Republic of China

    Meng-Xue Chen & Qi-Chang Lin

  4. Medical Intensive Care Unit, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian Province, People’s Republic of China

    Yan-Hua Wu

  5. Fujian Provincial Sleep-disordered Breathing Clinic Center, Fuzhou, Fujian Province, People’s Republic of China

    Qi-Chang Lin

  6. Laboratory of Respiratory Disease of the Fujian Medical University, Fuzhou, Fujian Province, People’s Republic of China

    Qi-Chang Lin

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  1. Qin Chen
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Correspondence to Qi-Chang Lin.

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Chen, Q., Chen, LD., Chen, MX. et al. The effect of continuous positive airway pressure on circulating malondialdehyde among obstructive sleep apnea patients: a meta-analysis. Sleep Breath 24, 1407–1415 (2020). https://doi.org/10.1007/s11325-019-01998-x

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  • DOI: https://doi.org/10.1007/s11325-019-01998-x

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