Top

Published in:

Open Access 01-12-2024 | Sleep Apnea | Research

Assessment of cephalometric parameters and correlation with the severity of the obstructive sleep apnea syndrome

Authors: Eugenio Garofalo, Giuseppe Neri, Lucilla Maria Perri, Nicola Lombardo, Giovanna Piazzetta, Alessandro Antonelli, Eugenio Biamonte, Vincenzo Bosco, Caterina Battaglia, Corrado Pelaia, Francesco Manti, Annalisa Pitino, Giovanni Tripepi, Andrea Bruni, Michele Morelli, Amerigo Giudice, Federico Longhini, The OSAS Study authors

Published in: Journal of Translational Medicine | Issue 1/2024

Abstract

Background

In individuals diagnosed with obstructive sleep apnea syndrome (OSAS), variations in craniofacial structure have been inconsistently documented, showing differing degrees of alteration between obese and nonobese patients. In addition, sleep disturbance has also been shown to induce disequilibrium in this population of patients. This pilot observational study aimed to assess craniofacial values in obese and nonobese subpopulations of patients with OSAS and their correlation and association with the severity of OSAS. We also assessed whether OSAS patients are characterized by an impaired equilibrium in relation to and associated with the severity of OSAS.

Methods

We included all consecutive adult patients with OSAS. Through cephalometry, we assessed the upper (UPa-UPp) and lower (LPa-LPp) pharynx diameters, superior anterior facial height (Sor-ANS), anterior facial height (ANS-Me), anterior vertical dimension (Sor-Me), posterior facial height (S-Go) and craniovertebral angle (CVA). Furthermore, we analyzed postural equilibrium through a stabilometric examination.

Results

Forty consecutive OSAS patients (45% female with a mean age of 56 ± 8.2 years) were included. The subgroup of nonobese patients had a reduced UPa-UPp (p = 0.02). Cephalometric measurements were correlated with the severity of OSAS in nonobese patients, whereas only Sor-ANS was correlated with the severity of OSAS in the obese subpopulation. In the overall population, altered craniofacial values are associated with severe OSAS. Although there are differences in equilibrium between obese and nonobese OSAS patients, the stabilometric measurements were not correlated or associated with OSAS severity.

Conclusion

Altered craniofacial values and compromised equilibrium in OSAS patients are linked to OSAS severity. Therefore, the management of OSAS should be tailored not only to weight management but also to craniofacial and postural rehabilitation to enhance patient outcomes.

Available only for authorised users

Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014;383(9918):736–47. https://doi.org/10.1016/S0140-6736(13)60734-5.CrossRefPubMed

Eckert DJ, White DP, Jordan AS, Malhotra A, Wellman A. Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets. Am J Respir Crit Care Med. 2013;188(8):996–1004. https://doi.org/10.1164/rccm.201303-0448OC.CrossRefPubMedPubMedCentral

Wellman A, Eckert DJ, Jordan AS, Edwards BA, Passaglia CL, Jackson AC, Gautam S, Owens RL, Malhotra A, White DP. A method for measuring and modeling the physiological traits causing obstructive sleep apnea. J Appl Physiol (1985). 2011;110(6):1627–37. https://doi.org/10.1152/japplphysiol.00972.2010.CrossRefPubMedPubMedCentral

Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an american academy of sleep medicine clinical practice guideline. J Clin Sleep Med. 2017;13(3):479–504. https://doi.org/10.5664/jcsm.6506.CrossRefPubMedPubMedCentral

Pevernagie DA, Gnidovec-Strazisar B, Grote L, Heinzer R, McNicholas WT, Penzel T, Randerath W, Schiza S, Verbraecken J, Arnardottir ES. On the rise and fall of the apnea-hypopnea index: a historical review and critical appraisal. J Sleep Res. 2020;29(4): e13066. https://doi.org/10.1111/jsr.13066.CrossRefPubMed

Lin WC, Huang CC, Chen HL, Chou KH, Chen PC, Tsai NW, Chen MH, Friedman M, Lin HC, Lu CH. Longitudinal brain structural alterations and systemic inflammation in obstructive sleep apnea before and after surgical treatment. J Transl Med. 2016;14(1):139. https://doi.org/10.1186/s12967-016-0887-8[pii].CrossRefPubMedPubMedCentral

Kendzerska T, Leung RS, Aaron SD, Ayas N, Sandoz JS, Gershon AS. Cardiovascular outcomes and all-cause mortality in patients with obstructive sleep apnea and chronic obstructive pulmonary disease (overlap syndrome). Ann Am Thorac Soc. 2019;16(1):71–81. https://doi.org/10.1513/AnnalsATS.201802-136OC.CrossRefPubMed

Ding H, Huang JF, Xie HS, Wang BY, Lin T, Zhao JM, Lin QC. The association between glycometabolism and nonalcoholic fatty liver disease in patients with obstructive sleep apnea. Sleep Breath. 2019;23(1):373–8. https://doi.org/10.1007/s11325-018-1744-1.CrossRefPubMed

You CR, Oh JH, Seo M, Lee HY, Joo H, Jung SH, Lee SH, Choi MG. Association between non-erosive reflux disease and high risk of obstructive sleep apnea in Korean population. J Neurogastroenterol Motil. 2014;20(2):197–204.CrossRefPubMedPubMedCentral

10.

Ayache M, Kellner P, Chiang A. Asthma exacerbation in the spouse of a patient with obstructive sleep apnea. J Clin Sleep Med. 2018;14(9):1631–2.CrossRefPubMedPubMedCentral

11.

Kuptanon T, Chukumnerd J, Leejakpai A, Preutthipan A. Reliability and validity of Thai version quality of life questionnaire (OSA-18) for pediatric obstructive sleep apnea. J Med Assoc Thai. 2015;98(5):464–71.PubMed

12.

Choi JW, Song JS, Lee YJ, Won TB, Jeong DU. Increased mortality in relation to insomnia and obstructive sleep Apnea in Korean patients studied with nocturnal polysomnography. J Clin Sleep Med. 2017;13(1):49–56. https://doi.org/10.5664/jcsm.6386.CrossRefPubMedPubMedCentral

13.

Mohammadieh A, Sutherland K, Cistulli PA. Sleep disordered breathing: management update. Intern Med J. 2017;47(11):1241–7. https://doi.org/10.1111/imj.13606.CrossRefPubMed

14.

Farrell PC, Richards G. Recognition and treatment of sleep-disordered breathing: an important component of chronic disease management. J Transl Med. 2017;15(1):114. https://doi.org/10.1186/s12967-017-1211-y[pii].CrossRefPubMedPubMedCentral

15.

Kuna ST, Woodson LC, Solanki DR, Esch O, Frantz DE, Mathru M. Effect of progressive mandibular advancement on pharyngeal airway size in anesthetized adults. Anesthesiology. 2008;109(4):605–12. https://doi.org/10.1097/ALN.0b013e31818709fa.CrossRefPubMed

16.

Qian Y, Tan JB, Wang T, Bressington D, Zhou HJ, Li MY, Liu XL. Quality appraisal and descriptive analysis of clinical practice guidelines for self-managed non-pharmacological interventions of cardiovascular diseases: a systematic review. J Transl Med. 2024;22(1):215. https://doi.org/10.1186/s12967-024-04959-5.CrossRefPubMedPubMedCentral

17.

Langaliya A, Alam MK, Hegde U, Panakaje MS, Cervino G, Minervini G. Occurrence of temporomandibular disorders among patients undergoing treatment for obstructive sleep apnoea syndrome (OSAS) using mandibular advancement device (MAD): a systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions. J Oral Rehabil. 2023;50(12):1554–63. https://doi.org/10.1111/joor.13574.CrossRefPubMed

18.

Barkhordarian A, Demerjian G, Chiappelli F. Translational research of temporomandibular joint pathology: a preliminary biomarker and fMRI study. J Transl Med. 2020;18(1):22. https://doi.org/10.1186/s12967-019-02202-0.CrossRefPubMedPubMedCentral

19.

Akpinar ME, Celikoyar MM, Altundag A, Kocak I. The comparison of cephalometric characteristics in nonobese obstructive sleep apnea subjects and primary snorers cephalometric measures in nonobese OSA and primary snorers. Eur Arch Otorhinolaryngol. 2011;268(7):1053–9. https://doi.org/10.1007/s00405-010-1448-z.CrossRefPubMed

20.

Tangugsorn V, Krogstad O, Espeland L, Lyberg T. Obstructive sleep apnea (OSA): a cephalometric analysis of severe and non-severe OSA patients. Part II: A predictive discriminant function analysis. Int J Adult Orthodon Orthognath Surg. 2000;15(3):179–91.PubMed

21.

Bharadwaj R, Ravikumar A, Krishnaswamy NR. Evaluation of craniofacial morphology in patients with obstructive sleep apnea using lateral cephalometry and dynamic MRI. Indian J Dent Res. 2011;22(6):739–48. https://doi.org/10.4103/0970-9290.94566.CrossRefPubMed

22.

Clavel L, Remy-Neris S, Skalli W, Rouch P, Lespert Y, Similowski T, Sandoz B, Attali V. Cervical spine hyperextension and altered posturo-respiratory coupling in patients with obstructive sleep apnea syndrome. Front Med (Lausanne). 2020;7:30. https://doi.org/10.3389/fmed.2020.00030.CrossRefPubMed

23.

Stevens D, Jackson B, Carberry J, McLoughlin J, Barr C, Mukherjee S, Oh A, McEvoy RD, Crotty M, Vakulin A. The impact of obstructive sleep apnea on balance, gait, and falls risk: a narrative review of the literature. J Gerontol A Biol Sci Med Sci. 2020;75(12):2450–60. https://doi.org/10.1093/gerona/glaa014.CrossRefPubMed

24.

Demir T, Aslan K, Demirkiran M. Evaluation of postural balance in patients with obstructive sleep apnoea syndrome. Neurol Neurochir Pol. 2020;54(1):83–9. https://doi.org/10.5603/PJNNS.a2019.0059.CrossRefPubMed

25.

Ciavarella D, Lorusso M, Campobasso A, Cazzolla AP, Montaruli G, Burlon G, Lo Muzio E, Laurenziello M, Tepedino M. Craniofacial morphology in obstructive sleep apnea patients. J Clin Exp Dent. 2023;15(12):e999–1006. https://doi.org/10.4317/jced.61104.CrossRefPubMedPubMedCentral

26.

Tepedino M, Illuzzi G, Laurenziello M, Perillo L, Taurino AM, Cassano M, Guida L, Burlon G, Ciavarella D. Craniofacial morphology in patients with obstructive sleep apnea: cephalometric evaluation. Braz J Otorhinolaryngol. 2022;88(2):228–34. https://doi.org/10.1016/j.bjorl.2020.05.026.CrossRefPubMed

27.

Soares MM, Romano FL, Dias F, de Souza JF, de Almeida LA, Miura CS, Itikawa CE, Matsumoto MA, Anselmo-Lima WT, Valera FCP. Association between the intensity of obstructive sleep apnea and skeletal alterations in the face and hyoid bone. Braz J Otorhinolaryngol. 2022;88(3):331–6. https://doi.org/10.1016/j.bjorl.2020.06.008.CrossRefPubMed

28.

Stipa C, Cameli M, Sorrenti G, Ippolito DR, Pelligra I, Alessandri-Bonetti G. Relationship between cephalometric parameters and the apnoea-hypopnoea index in OSA patients: a retrospective cohort study. Eur J Orthod. 2020;42(1):101–6. https://doi.org/10.1093/ejo/cjz038.CrossRefPubMed

29.

Naughton MT, Monteith BD, Manton DJ, Dever P, Schachter LM, O’Brien PE, Dixon JB. Shorter mandibular length is associated with a greater fall in AHI with weight loss. J Clin Sleep Med. 2015;11(4):451–6. https://doi.org/10.5664/jcsm.4604.CrossRefPubMedPubMedCentral

30.

von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–9. https://doi.org/10.1016/j.ijsu.2014.07.013.CrossRef

31.

Hwang SH, Guilleminault C, Park CS, Kim TW, Hong SC. Usefulness of adenotonsillar size for prediction of severity of obstructive sleep apnea and flow limitation. Otolaryngol Head Neck Surg. 2013;149(2):326–34. https://doi.org/10.1177/0194599813490892.CrossRefPubMed

32.

Neri G, Cazzato F, Mastronardi V, Pugliese M, Centurione MA, Di Pietro R, Centurione L. Ultrastructural regenerating features of nasal mucosa following microdebrider-assisted turbinoplasty are related to clinical recovery. J Transl Med. 2016;14(1):164. https://doi.org/10.1186/s12967-016-0931-8.CrossRefPubMedPubMedCentral

33.

Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF, Redline S, Strohl KP, Davidson Ward SL, Tangredi MM. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American academy of sleep medicine. J Clin Sleep Med. 2012;8(5):597–619. https://doi.org/10.5664/jcsm.2172.CrossRefPubMedPubMedCentral

34.

Tamisier R, Bocquillon V, Treptow E, Destors M, Salvat M, Borrel E, Pepin JL. Prevalence and factors contributing to daytime and nocturnal hypoxemia in chronic heart failure patients. Respiration. 2019;97(3):213–22. https://doi.org/10.1159/000490734.CrossRefPubMed

35.

Laranjo F, Pinho T. Cephalometric study of the upper airways and dentoalveolar height in open bite patients. Int Orthod. 2014;12(4):467–82. https://doi.org/10.1016/j.ortho.2014.10.005.CrossRefPubMed

36.

Rocabado M. Biomechanical relationship of the cranial, cervical, and hyoid regions. J Craniomandibular Pract. 1983;1(3):61–6. https://doi.org/10.1080/07345410.1983.11677834.CrossRefPubMed

37.

Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Loube DL, Owens J, Pancer JP, Wise M. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005;28(4):499–521. https://doi.org/10.1093/sleep/28.4.499.CrossRefPubMed

38.

Mehta A, Qian J, Petocz P, Darendeliler MA, Cistulli PA. A randomized, controlled study of a mandibular advancement splint for obstructive sleep apnea. Am J Respir Crit Care Med. 2001;163(6):1457–61. https://doi.org/10.1164/ajrccm.163.6.2004213.CrossRefPubMed

39.

Ciavarella D, Lo Russo L, Mastrovincenzo M, Padalino S, Montaruli G, Giannatempo G, Cassano M, Laino L, Lo Muzio L. Cephalometric evaluation of tongue position and airway remodelling in children treated with swallowing occlusal contact intercept appliance (S.O.C.I.A.). Int J Pediatr Otorhinolaryngol. 2014;78(11):1857–60. https://doi.org/10.1016/j.ijporl.2014.08.008.CrossRefPubMed

40.

Hotwani K, Sharma K, Jaiswal A. Evaluation of tongue/mandible volume ratio in children with obstructive sleep apnea. Dental Press J Orthod. 2018;23(4):72–8. https://doi.org/10.1590/2177-6709.23.4.072-078.oar.CrossRefPubMedPubMedCentral

41.

Tabatabaei Balaei A, Sutherland K, Cistulli P, de Chazal P. Prediction of obstructive sleep apnea using facial landmarks. Physiol Meas. 2018;39(9): 094004. https://doi.org/10.1088/1361-6579/aadb35.CrossRefPubMed

42.

Tepedino M, Iancu-Potrubacz M, Ciavarella D, Masedu F, Marchione L, Chimenti C. Expansion of permanent first molars with rapid maxillary expansion appliance anchored on primary second molars. J Clin Exp Dent. 2018;10(3):e241–7. https://doi.org/10.4317/jced.54585.CrossRefPubMedPubMedCentral

43.

Endo S, Mataki S, Kurosaki N. Cephalometric evaluation of craniofacial and upper airway structures in Japanese patients with obstructive sleep apnea. J Med Dent Sci. 2003;50(1):109–20.PubMed

44.

Morin R, Mauger JF, Amaratunga R, Imbeault P. The effect of acute intermittent hypoxia on postprandial triglyceride levels in humans: a randomized crossover trial. J Transl Med. 2021;19(1):268. https://doi.org/10.1186/s12967-021-02933-z.CrossRefPubMedPubMedCentral

45.

Lee RW, Petocz P, Prvan T, Chan AS, Grunstein RR, Cistulli PA. Prediction of obstructive sleep apnea with craniofacial photographic analysis. Sleep. 2009;32(1):46–52.PubMedPubMedCentral

46.

Tyan M, Espinoza-Cuadros F, Fernandez Pozo R, Toledano D, Lopez Gonzalo E, Alcazar Ramirez JD, Hernandez Gomez LA. Obstructive sleep apnea in women: study of speech and craniofacial characteristics. JMIR Mhealth Uhealth. 2017;5(11): e169. https://doi.org/10.2196/mhealth.8238.CrossRefPubMedPubMedCentral

47.

Rintala A, Nordstrom R, Partinen M, Ranta R, Sjoblad A. Cephalometric analysis of the obstructive sleep apnea syndrome. Proc Finn Dent Soc. 1991;87(1):177–82.PubMed

48.

Battagel JM, L’Estrange PR. The cephalometric morphology of patients with obstructive sleep apnoea (OSA). Eur J Orthod. 1996;18(6):557–69. https://doi.org/10.1093/ejo/18.6.557.CrossRefPubMed

49.

Zucconi M, Ferini-Strambi L, Palazzi S, Curci C, Cucchi E, Smirne S. Craniofacial cephalometric evaluation in habitual snorers with and without obstructive sleep apnea. Otolaryngol Head Neck Surg. 1993;109(6):1007–13. https://doi.org/10.1177/019459989310900606.CrossRefPubMed

50.

deBerry-Borowiecki B, Kukwa A, Blanks RH. Cephalometric analysis for diagnosis and treatment of obstructive sleep apnea. Laryngoscope. 1988;98(2):226–34. https://doi.org/10.1288/00005537-198802000-00021.CrossRefPubMed

51.

Riley RW, Powell NB, Guilleminault C. Obstructive sleep apnea and the hyoid: a revised surgical procedure. Otolaryngol Head Neck Surg. 1994;111(6):717–21. https://doi.org/10.1177/019459989411100604.CrossRefPubMed

52.

Djupesland G, Lyberg T, Krogstad O. Cephalometric analysis and surgical treatment of patients with obstructive sleep apnea syndrome A preliminary report. Acta Otolaryngol. 1987;103(5–6):551–7.PubMed

53.

Neelapu BC, Kharbanda OP, Sardana HK, Balachandran R, Sardana V, Kapoor P, Gupta A, Vasamsetti S. Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: a systematic review and meta-analysis of cephalometric studies. Sleep Med Rev. 2017;31:79–90. https://doi.org/10.1016/j.smrv.2016.01.007.CrossRefPubMed

54.

Armalaite J, Lopatiene K. Lateral teleradiography of the head as a diagnostic tool used to predict obstructive sleep apnea. Dentomaxillofac Radiol. 2016;45(1):20150085. https://doi.org/10.1259/dmfr.20150085.CrossRefPubMed

55.

Tangugsorn V, Krogstad O, Espeland L, Lyberg T. Obstructive sleep apnoea: multiple comparisons of cephalometric variables of obese and non-obese patients. J Craniomaxillofac Surg. 2000;28(4):204–12. https://doi.org/10.1054/jcms.2000.0147.CrossRefPubMed

56.

Degache F, Goy Y, Vat S, Haba Rubio J, Contal O, Heinzer R. Sleep-disordered breathing and daytime postural stability. Thorax. 2016;71(6):543–8. https://doi.org/10.1136/thoraxjnl-2015-207490.CrossRefPubMed

57.

Archbold KH, Borghesani PR, Mahurin RK, Kapur VK, Landis CA. Neural activation patterns during working memory tasks and OSA disease severity: preliminary findings. J Clin Sleep Med. 2009;5(1):21–7.CrossRefPubMedPubMedCentral

58.

Liang YY, Chen J, Peng M, Zhou J, Chen X, Tan X, Wang N, Ma H, Guo L, Zhang J, Wing YK, Geng Q, Ai S. Association between sleep duration and metabolic syndrome: linear and nonlinear Mendelian randomization analyses. J Transl Med. 2023;21(1):90. https://doi.org/10.1186/s12967-023-03920-2.CrossRefPubMedPubMedCentral

59.

Redfern MS, Yardley L, Bronstein AM. Visual influences on balance. J Anxiety Disord. 2001;15(1–2):81–94. https://doi.org/10.1016/s0887-6185(00)00043-8.CrossRefPubMed

60.

Micarelli A, Liguori C, Viziano A, Izzi F, Placidi F, Alessandrini M. Integrating postural and vestibular dimensions to depict impairment in moderate-to-severe obstructive sleep apnea syndrome patients. J Sleep Res. 2017;26(4):487–94. https://doi.org/10.1111/jsr.12516.CrossRefPubMed

61.

Kayabasi S, Iriz A, Cayonu M, Cengiz B, Acar A, Boynuegri S, Mujdeci B, Eryilmaz A. Vestibular functions were found to be impaired in patients with moderate-to-severe obstructive sleep apnea. Laryngoscope. 2015;125(5):1244–8. https://doi.org/10.1002/lary.25021.CrossRefPubMed

62.

Gallina S, Dispenza F, Kulamarva G, Riggio F, Speciale R. Obstructive sleep apnoea syndrome (OSAS): effects on the vestibular system. Acta Otorhinolaryngol Ital. 2010;30(6):281–4.PubMedPubMedCentral

63.

Sowerby LJ, Rotenberg B, Brine M, George CF, Parnes LS. Sleep apnea, daytime somnolence, and idiopathic dizziness—a novel association. Laryngoscope. 2010;120(6):1274–8. https://doi.org/10.1002/lary.20899.CrossRefPubMed

64.

Nahm FS. Nonparametric statistical tests for the continuous data: the basic concept and the practical use. Korean J Anesthesiol. 2016;69(1):8–14. https://doi.org/10.4097/kjae.2016.69.1.8.CrossRefPubMedPubMedCentral

65.

Hammer GP, du Prel JB, Blettner M. Avoiding bias in observational studies: part 8 in a series of articles on evaluation of scientific publications. Dtsch Arztebl Int. 2009;106(41):664–8. https://doi.org/10.3238/arztebl.2009.0664.CrossRefPubMedPubMedCentral

Title: Assessment of cephalometric parameters and correlation with the severity of the obstructive sleep apnea syndrome
Authors: Eugenio Garofalo
Giuseppe Neri
Lucilla Maria Perri
Nicola Lombardo
Giovanna Piazzetta
Alessandro Antonelli
Eugenio Biamonte
Vincenzo Bosco
Caterina Battaglia
Corrado Pelaia
Francesco Manti
Annalisa Pitino
Giovanni Tripepi
Andrea Bruni
Michele Morelli
Amerigo Giudice
Federico Longhini
The OSAS Study authors
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Sleep Apnea
Published in: Journal of Translational Medicine / Issue 1/2024
Electronic ISSN: 1479-5876
DOI: https://doi.org/10.1186/s12967-024-05194-8

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2024

Transcript and protein signatures derived from shared molecular interactions across cancers are associated with mortality

Solobacterium moorei promotes the progression of adenomatous polyps by causing inflammation and disrupting the intestinal barrier

Characterizing neuroinflammation and identifying prenatal diagnostic markers for neural tube defects through integrated multi-omics analysis

Conserved genes regulating human sex differentiation, gametogenesis and fertilization

MiR-146a reduces fibrosis after glaucoma filtration surgery in rats

Standardizing digital biobanks: integrating imaging, genomic, and clinical data for precision medicine

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials