Meta-analyses of the Association of Sleep Apnea with Insulin Resistance, and the Effects of CPAP on HOMA-IR, XXXX , and Visceral Adipose Fat.

@entity1 @entity1254 @entity1661 @entity27
Objective: We sought to conduct an updated meta-analysis of randomized controlled trials (RCTs) on the effect of continuous positive airway pressure (CPAP) on insulin resistance, as measured by homeostasis model assessment of insulin resistance (HOMA-IR), @entity1661 ( @entity1661 ), and @entity1254 . Additionally, we performed a separate meta-analysis and meta-regression of studies on the association of insulin resistance and @entity27 ( @entity27 ). Methods: All included studies were searched from PubMed (from conception to March 15, 2014). Data were pooled across all included RCTs as the mean difference in HOMA-IR and @entity1661 , and as the standardized mean difference in the case of @entity1254 analysis. From the included case-control studies, data on the difference of HOMA-IR between cases and controls were pooled across all studies, as the standardized mean difference (SMD). Results: There was a significant difference in HOMA-IR (-0.43 [95% CIs: -0.75 to -0.11], p = 0.008) between CPAP treated and non CPAP treated @entity1 . However, there was no significant difference in @entity1661 or @entity1254 ; (-47.93 [95% CI: -112.58 to 16.72], p = 0.14) and (-0.06 [95% CI: -0.28 to 0.15], p = 0.56), respectively. Meta-analysis of 16 case-control studies showed a pooled SMD in HOMA-IR of 0.51 (95% CI: 0.28 to 0.75), p  <= 0.001, between cases and controls. Conclusions: The results of our meta-analyses show that CPAP has a favorable effect on insulin resistance. This effect is not associated with any significant changes in total @entity1254 levels or amount of @entity1661 . Our findings also confirm a significant association between @entity27 and insulin resistance.
