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Systolic and diastolic blood pressure were measured at week 48 High-sensitivity C-reactive protein (hsCRP) as a marker of systemic inflammation Lipid profiles, including triglycerides and cholesterol fractions Insulin sensitivity assessed using fasting insulin and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) Mediation analyses evaluated whether health improvements were attributable solely to weight loss or whether improvements in sleep metrics, including AHI and sleep apnea-specific hypoxic burden, contributed independently