[Pp.18.11] Influence of Cpap Therapy on Endothelial Function in Patients With Type 2 Diabetes According to Flow-Mediated Vasodilation

Objective: to assess the dynamics of parameters of endothelial function in patients with type 2 diabetes, suffering from medium to severe obstructive sleep apnea (OSA). Design and method: 42 subjects with diabetes and moderate to severe OSA were examined. During 12 weeks 22 patients (group 1 CPAP) in addition to antihypertensive treatment (AHT) received CPAP-therapy with «SOMNObalance» (Weinmann, Germany). Control group (C) included 20 patients without additional treatment by CPAP. The subjects were matched by age, sex, height, office blood pressure values. All enrolled patients had arterial hypertension 1–2 degrees. Assessment of respiratory disorders during sleep was carried out using cardio-respiratory monitoring device SOMNOcheck2 (Weinmann, Germany). Endothelial function was evaluated by the ultrasonic device MyLab 90 (Esaote, Italy). Index of reactivity (IR), flow-mediated dilation (FMD), the diameter of the common carotid artery (DCCA) and the intima-media thickness (IMT) on the right and left were assessed. Results: Initially there were no significant differences between groups for all parameters of comparison, reflecting endothelial function. In CPAP group baseline values of IR were1,3 ± 0,3, FMD - 8,4 ± 4,9%, DCCA - 7 ± 1,1 mm, IMT - 1,1 ± 0,2 mm. During the CPAP-therapy IR increased to 1,5 ± 0,3 (15,7%; p < 0,05), FMD to 12,2 ± 3,0% (45,2%; p < 0,05). DCCA and IMT values after 12 weeks decreased to 6,95 ± 1,1 mm (ns) and 1,0 ± 0,1 mm, respectively (p < 0,05). In patients of control group the IR at baseline was 1,2 (1,1; 1,4), FMD - 7,5 (5; 9,52)%, DCCA- 6,2 (5,45; 6,5) mm, IMT - 1,0 ± 0,1 mm. In the control group FMD increased to 8,9 ± 5,3% (15,5%; p < 0,05). IR values, IMT and DCCA were not significantly changed in control group, and amounted to 1,5 ± 0,4; 5,7 ± 1,0 mm, and 1,0 ± 0,1 m/s, respectively. Conclusions: the application of CPAP in patients with diabetes and apnea syndrome contributes to a significant improvement in endothelial function according to flow-mediated dilation.