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Effect of mandibular advancement therapy on inflammatory and metabolic biomarkers in patients with severe obstructive sleep apnoea: a randomised controlled trial
  1. Sylvain Recoquillon1,
  2. Jean-Louis Pépin2,3,
  3. Bruno Vielle4,
  4. Ramaroson Andriantsitohaina1,
  5. Vanessa Bironneau5,
  6. Frédérique Chouet-Girard6,
  7. Bernard Fleury7,
  8. François Goupil8,
  9. Sandrine Launois7,
  10. M Carmen Martinez1,
  11. Nicole Meslier1,9,
  12. Xuan-Lan Nguyen7,
  13. Audrey Paris8,
  14. Pascaline Priou1,9,
  15. Renaud Tamisier2,3,
  16. Wojciech Trzepizur1,9,
  17. Frédéric Gagnadoux1,9
  1. 1 Université d’Angers, INSERM UMR 1063, Angers, France
  2. 2 HP2, INSERM UMR 1042, Université Grenoble Alpes, Grenoble, France
  3. 3 Laboratoire EFCR, Clinique Universitaire de Physiologie, CHU de Grenoble, Grenoble, France
  4. 4 Centre de Recherche Clinique, CHU d’Angers, Angers, France
  5. 5 Service de Pneumologie, Université de Poitiers, CHU, Poitiers, France
  6. 6 Service de Chirurgie Maxillo-faciale et Stomatologie, Centre Hospitalier, Le Mans, France
  7. 7 Unité de Sommeil, Université Paris VI, Hôpital Saint-Antoine, Paris, France
  8. 8 Service de Pneumologie, Centre Hospitalier, Le Mans, France
  9. 9 Département de Pneumologie, CHU d’Angers, Angers, France
  1. Correspondence to Prof. Frédéric Gagnadoux, Département de Pneumologie, CHU, Angers 49100, France; FrGagnadoux{at}


Systemic inflammation and metabolic disorders are among the mechanisms linking obstructive sleep apnoea (OSA) and cardiovascular disease (CVD). In 109 patients with severe OSA and no overt CVD, biomarkers of inflammation (C reactive protein, interleukin-6, tumour necrosis factor-α and its receptors, adiponectin, leptin and P-selectin), glucose and lipid metabolism, and N-terminal pro-brain natriuretic peptide, were measured before and after 2 months of treatment with a mandibular advancement device (MAD) (n=55) or a sham device (n=54). MAD reduced the Apnoea–Hypopnoea Index (p<0.001) but had no effect on circulating biomarkers compared with the sham device, despite high treatment adherence (6.6 hour/night).

Trial registration number NCT01426607.

  • obstructive sleep apnoea syndrome
  • mandibular advancement device
  • inflammation
  • cytokines

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  • Contributors SR, J-LP, BV, RA, FC-G, BF, FG, SL, CM, NM, VB, X-LN, AP, PP, RT, WT and FG were substantially involved in the design of the study and critical revision of the paper for important intellectual content. SR, FG, J-LP, BV and WT were substantially involved in drafting the article. All authors were substantially involved in data acquisition, data analysis and/or interpretation of data. They critically revised the article for important intellectual content.

  • Funding This study was supported by a grant from the French Ministry of Health (PHRC-I 2010-06). J-LP and RT are supported by the French National Research Agency in the framework of the ‘Investissements d’avenir’ programme (ANR-15-IDEX-02).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Comité de Protection des Personnes, Ouest II, Angers, France; No. 2010/14.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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