Evidence map›Paper›PMID 23607839›Full record

SynthesisAnnals of the American Thoracic Society2013

Meta-analysis: continuous positive airway pressure improves insulin resistance in patients with sleep apnea without diabetes.

Imran H Iftikhar, Meena F Khan, Aneesa Das, Ulysses J Magalang

Erratum issued Registry-linked trialOpen access · greenAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of the American Thoracic Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03432390 (Continuous Positive Airway Pressure During General Anesthesia Induction For Elective Pediatric Surgery), which is not on this map. Cited by 56 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 8 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03432390 nacompletednot on this mapstarted 2018, after this paper: background citation

Continuous Positive Airway Pressure During General Anesthesia Induction For Elective Pediatric Surgery: Randomized Clinical Trial

TypeinterventionalSponsorInstituto Materno Infantil Prof. Fernando FigueiraRan2018 to 2019Enrolled72ConditionsContinuous Positive Airway Pressure, Hypoxia, General AnesthesiaArmsContinuous Positive Airway Pressure, Open system ventilation
3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 8 syntheses or guidelines pooled it, 111 citations in OpenAlex.

  1. Pooled it
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  7. Meta-analyses of the Association of Sleep Apnea with Insulin Resistance, and the Effects of CPAP on HOMA-IR, Adiponectin, and Visceral Adipose Fat.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2015
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4 · The record

Corrections and comments

  • Erratum issued
5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Imran H IftikharDepartment of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of South Carolina, Columbia, SC, USA. Imran.Iftikhar@uscmed.sc.edu
Meena F Khan
Aneesa Das
Ulysses J Magalang
The Ohio State University Wexner Medical Center · USUniversity of South Carolina · US

Funding

University of Iowa Clinical and Translational Science Program (TL1)UL1RR025755 · NCRR · OHIO STATE UNIVERSITY · PI JACKSON, REBECCA D · 2008 to 2011
$26.3M
Intermittent hypoxia, adiponectin, and insulin resistance in cardiovascular riskR01HL093463 · NHLBI · OHIO STATE UNIVERSITY · PI MAGALANG, ULYSSES J, PARINANDI, NARASIMHAM LAXMI · 2010 to 2013
$1.5M
NCRR NIH HHS UL1 RR025755NHLBI NIH HHS HL093463NHLBI NIH HHS R01 HL093463
6 · The paper itself

Abstract

rationaleObstructive sleep apnea (OSA) is an independent risk factor for the development of insulin resistance (IR). Treatment with continuous positive airway pressure (CPAP) for OSA has shown conflicting results on IR.

objectivesTo conduct a meta-analysis of randomized controlled trials (RCTs) that have evaluated the effect of CPAP on a validated index of IR, the homeostasis model assessment of insulin resistance (HOMA-IR).

methodsPubMed and Embase were searched through August 10, 2012. Two independent reviewers screened citations to identify trials of the effect of CPAP on HOMA-IR. Data were extracted for postintervention HOMA-IR values. MEASUREMENTS AND MAIN

resultsA total of five studies that enrolled 244 subjects (83% male) met the inclusion criteria. None of the subjects in the included studies had diabetes. The pooled estimate of the difference in means in HOMA-IR between the CPAP and sham CPAP/control groups was -0.44 (95% confidence interval, -0.82 to -0.06; P = 0.02). The funnel plot does not suggest the presence of any publication bias. The I-squared index for the data on difference in means in HOMA-IR between the CPAP and sham CPAP/control groups was 0.00 (P = 0.61).

conclusionsThe pooled estimate of RCTs shows a favorable effect of CPAP on insulin resistance as measured by HOMA-IR in patients with OSA without diabetes. The effect size on HOMA-IR is modest, but not insignificant, when compared with the effects of thiazolidinedione in nondiabetic patients with metabolic syndrome. Further research and RCTs are warranted involving a larger number of patients and longer treatment periods to determine the beneficial effects of CPAP on IR.

Indexed as

Diabetes MellitusBlood GlucoseContinuous Positive Airway PressureHumansInsulin ResistancePrediabetic StateSleep Apnea, ObstructiveBlood Glucose

Identifiers

PMID23607839
PMCPMC3960898
OpenAlexW2125185007

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.