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This prospective observational study aimed to evaluate biomarker changes during the first six months of home mechanical ventilation in OHS patients and explore potential patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We assessed hematological, nutritional, muscle, cardiovascular, inflammatory, and fatigue-related biomarkers in OHS patients starting goal-directed noninvasive ventilation aimed to achieve normocapnia at baseline, then 1, 3, and 6\u00a0months after initiation of treatment. Predictors of five-year survival were assessed. Subgroup analyses were performed based on initiation type and apnea\u2013hypopnea index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We observed significant improvement in clinical parameters and red cell distribution width, ferritin, total protein, albumin, creatinine, creatine-kinase, total calcium, interleukin-6, and apolipoprotein A1 values during the first 6\u00a0months of treatment. Patients with low AHI and those acutely initiated exhibited persistently elevated activin A levels at six months, suggesting incomplete biological recovery and persisting inflammatory-metabolic alterations. Albumin and PaCO\n                      <jats:sub>2<\/jats:sub>\n                      normalization at six months were associated with survival in exploratory analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Initiation of home mechanical ventilation is associated with versatile biomarker changes in OHS patients. Persistent differences in certain biomarkers could help identify underlying heterogeneity. Further studies are needed to validate these findings and explore the role of biomarker profiling in OHS management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11325-026-03785-x","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:53:16Z","timestamp":1787583196000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomarker changes during long-term noninvasive ventilation in obesity hypoventilation syndrome: a prospective observational study"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4046-4681","authenticated-orcid":false,"given":"Luca","family":"Valko","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4168-5440","authenticated-orcid":false,"given":"Vivien","family":"Moro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9958-2455","authenticated-orcid":false,"given":"Szabolcs","family":"Baglyas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9750-1682","authenticated-orcid":false,"given":"Blanka","family":"Mezo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eszter","family":"Podmaniczky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1761-7982","authenticated-orcid":false,"given":"Zoltan","family":"Prohaszka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-1514","authenticated-orcid":false,"given":"Andras","family":"Lorx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"3785_CR1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0097-2018","author":"JF Masa","year":"2019","unstructured":"Masa JF, P\u00e9pin JL, Borel JC, Mokhlesi B, Murphy PB, S\u00e1nchez-Quiroga M (2019) Obesity hypoventilation syndrome. 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