scholarly journals Association of Metabolic Syndrome With Prevalence of Obstructive Sleep Apnea and Remission After Sleeve Gastrectomy

2021 ◽  
Vol 12 ◽  
Author(s):  
Yufei Chen ◽  
Lijia Chen ◽  
Lingxia Ye ◽  
Jiabin Jin ◽  
Yingkai Sun ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleeve Gastrectomy ◽  
Sleep Apnea ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Metabolic States ◽  
Obstructive Sleep ◽  
Metabolically Healthy

Obesity is an important risk factor for metabolic syndrome and obstructive sleep apnea (OSA). Bariatric surgery has been shown to effectively reduce weight and obesity-related comorbidities. However, the prevalence and severity of OSA in obese patients with different baseline metabolic states and the improvements of OSA after bariatric surgery remain unknown. The main aims of this study were to ascertain the prevalence of OSA in young Chinese obese patients with different metabolic states and to evaluate their respective OSA remission after laparoscopic sleeve gastrectomy. We first performed a cross-sectional study involving 123 metabolically healthy obese patients and 200 metabolically unhealthy obese patients (who had the same age and BMI ranges) to estimate the prevalence of OSA at baseline. Then we performed a retrospective study, which was registered at ClinicalTrials.gov (ref. NCT02653430) of 67 patients who underwent laparoscopic sleeve gastrectomy to evaluate the remission of OSA. Metabolically healthy and unhealthy obese patients had similar apnea-hypopnea index levels (16.6 ± 22.0 vs. 16.7 ± 18.7 events/h, P = 0.512) and prevalence of OSA (66.7% vs. 69.0%, P = 0.662). Male sex, age, waist circumference and lower liver-to-spleen ratio were independent risk factors for OSA. After laparoscopic sleeve gastrectomy, no difference was found in the decrease in body mass index (BMI) change (10.8 ± 4.8 vs. 10.8 ± 3.0 kg/m2, P = 0.996) or the decrease in the apnea-hypopnea index (18.9 ± 24.6 vs. 17.0 ± 24.0 events/h, P = 0.800). The remission of moderate-to-severe OSA was observed in the MHO (36.3%; 54.5–18.2%, P = 0.125) and MUO (32.2%; 66.1–33.9%, P = 0.001) patients. These results suggest that, in patients with obesity, metabolic syndrome does not add extra risk for the prevalence or severity of OSA. Both metabolically healthy and unhealthy obese patients could benefit equally from laparoscopic sleeve gastrectomy in terms of weight loss and obstructive sleep apnea remission.

scholarly journals The Effect of Laparoscopic Sleeve Gastrectomy on Obstructive Sleep Apnea Syndrome

2018 ◽  
Author(s):  
Tuğrul Çakır ◽  
Hülya Eyigör ◽  
Arif Aslaner ◽  
Nurullah Bülbüller ◽  
Mehmet Tahir Oruç ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleeve Gastrectomy ◽  
Sleep Apnea ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Morbidly Obese ◽  
Safe Procedure ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Severely Obese ◽  
The Mean

Background: The repeated episode of obstructive hypopnea and apnea during sleep is defined as obstructive sleep apnea (OSA) and it is a common condition in obese patients. Studies performing bariatric surgery have demonstrated a significant improvement in OSA by weight reduction. In this prospective study we aimed to explore the efficacy and safety of Laparoscopic Sleeve Gastrectomy (LSG) on OSAS among severely obese patients. Material and Methods: A total of 32 morbidly obese patients who underwent LSG for morbid obesity were included in this study. Body weight, height, body mass index (BMI) and standard overnight polysomnography (PSG) were measured at before and after LSG at the 6th month.  Results: 32 patients (27 female, 5 male) who have postoperative PSG's were included in this study. The mean age was 43.22±9.87 years old. The mean preoperative and postoperative BMIs were 50.36±8.14kg/m² and 37.27±7.93kg/m², respectively. The mean Epworth sleepiness scale determined as 5.84±4.65 preoperatively and 2.19±3.55 postoperatively. The preoperative and postoperative sleep efficiency test of the patients was determined as 83.34±9.68 and 88.94±6.90 respectively. AHI average at the preoperative PSG was 31.47±26.34, while 9.35±10:34 at postoperative 6 months and found as statistically significant. Conclusion: Our data showed that LSG is an efficient and safe procedure on severely obese patients and showed a predictive remission of clinical and sleep parameters of patients with OSA by analyzing PSG data during the first 6 months.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

scholarly journals Interlink between Obesity Hypoventilation Syndrome and Obstructive Sleep Apnea. Do we need to screen patients for OHS in obese OSA patients?

2020 ◽  
Vol 4 (1) ◽  
pp. 17-20
Author(s):  
S.S. Dhakal ◽  
R. Maskey ◽  
M. Bhattarai
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Research Centre ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Obesity Hypoventilation Syndrome ◽  
Arterial Blood ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Introduction: Around 90% of patients with OHS have coexistent obstructive sleep apnea (OSA) defined by an apnea–hypopnea index (AHI) >5 events/h, with nearly 70% having severe OSA (AHI > 30 events/h). Prevalence of OHS is between 8% and 20% in obese patients referred to sleep centers for evaluation of SDB. As prevalence of OHS in OSA patients data from Nepal is not available we planned to carry out the study and to address gaps in diagnosis and management. Methodology: This is a cross sectional observational study done in OM hospital and research centre from 2018 January to 2019 June. Awake daytime Arterial blood gas ( ABG) was obtained and patients having PaCO2 more than 45 mmHg were diagnosed as obesity hypoventilation syndrome in a recently diagnosed patients with OSA. Results: 32 patients diagnosed to have OSA and whose BMI is more than 30 were included in the study. Among 32 patients 26 (81.25%) were male and 6 (18.75) were female. Among all patients who underwent level A polysomnography 3 (12.5%) had mild OSA,4(16.66%) had moderate and 17 (53.12%) had severe OSA. 8 (25%) patients had normal diagnostic polysomnography. Among these patients 3(12.5%) who had mild OSA has BMI between 30-35,16 (66.66%) patients who had BMI between 30-35, 2 had mild 3 had moderate and 11 had severe OSA. Patients with BMI more than 40,5 (28.3%) had OSA among which 21 had moderate and 4 had severe OSA. Conclusions: As OHS is often misdiagnosed even in patients with severe obesity, we strongly recommended screening in obese patients with OSA for OHS as early recognition and effective treatment are important in improving morbidity and mortality in this group of patients.

The interaction of obesity and craniofacial deformity in obstructive sleep apnea

2020 ◽  
pp. 20200425
Author(s):  
Liping Huang ◽  
Xuemei Gao
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Soft Tissues ◽  
Normal Weight ◽  
The Body ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Weight Group ◽  
Normal Weight Group ◽  
Obstructive Sleep

Objective: Both obesity and craniofacial deformity are important etiologies of obstructive sleep apnea (OSA). The present research aimed to explore their interaction and different impacts on OSA severity. Methods: A total of 207 consecutive OSA patients (169 males, 38 females) were included in the research. Based on the body mass index (BMI) value, patients were divided into 77 normal-weight patients (BMI <24 kg m−2), 105 overweight patients (24 ≤ BMI<28 kg m−2) and 26 obese patients (BMI ≥28 kg m−2). All accepted overnight polysomnography and standard lateral cephalogram. Cephalometric measurements involved 25 cephalometric variables. The correlations between these cephalometric variables, BMI and the apnea-hypopnea index (AHI) were evaluated. Results: For the whole sample after controlling for gender and age, stepwise regression analysis showed that the factors affecting AHI were increased BMI, narrowing posterior airway space, inferior displacement of hyoid and elongation of the tongue. When grouped by BMI, normal-weight group exhibited with more reduced maxillary length and mandible length, and steeper mandible plane than overweight and obese patients (p < 0.0167). Obese group showed least skeletal restriction and most prominent soft tissues enlargement (p < 0.0167). However, these skeletal indexes were not statistically correlated with AHI. Conclusions: Obesity and skeletal malformations were both etiological factors of OSA, but obesity seemed to have a greater influence on AHI severity in all kinds of obese and thin OSA patients. Only in normal-weight group, it was affected by both cephalometric variables and BMI.

scholarly journals Association between genetic variants in metabolic syndrome-related genes and risk of obstructive sleep apnea among a Chinese population

2020 ◽  
Author(s):  
Yuanyuan Cao ◽  
Nanfang Li ◽  
Qing Zhu ◽  
Ting Wu ◽  
Xintian Cai ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Genetic Variants ◽  
Chinese Population ◽  
Apnea Hypopnea Index ◽  
Causal Mechanism ◽  
Obstructive Sleep ◽  
Novel Variant ◽  
Pparg Gene

Abstract Background Despite the strong epidemiological association between Metabolic syndrome (MetS) and obstructive sleep apnea (OSA), the causal mechanism between the two remains not fully elucidated. We conducted a case-control study to evaluate the genetic association of twelve metabolic syndrome-related genes with OSA in Chinese subjects. Methods Targeted capture sequencing for twelve metabolic syndrome-related genes (EDN1, APOE, LEP, LEPR, IRS1, UCP1, ADIPOQ, PEMT, PPARG, SLC2A4, FABP2 and ADRA2A) were performed in 100 subjects including 50 patients with severe OSA and 50 non-OSA individuals. Possible associations between genetic variants and the risk of OSA were determined by logistic regression analyses. Results From the multiple genes studied, only the rs12486170 variant in PPARG gene was associated with OSA risk after adjusting for potential confounding factors. The PPARG rs12486170 AG/GG genotype was found to decrease the risk for OSA [dominant model: adjusted odds ratio (AOR) = 0.211, 95% confidence interval (CI) = 0.055-0.800, P = 0.022] compared with AA genotype. Moreover, subjects with the rs12486170 AG/GG genotype had a significantly lower apnea-hypopnea index (AHI) (median: 2.50 vs. 50.90 events/h, P = 0.019) and higher lowest oxygen saturation (LSaO2) (median: 87% vs. 75%, P = 0.040) compared with those with the AA genotype. Conclusions We identified a novel variant of PPARG in subjects with OSA, and specifically found an association between rs12486170 polymorphisms and OSA risk in a Chinese population.

scholarly journals The influence of obstructive sleep apnea syndrome on anthropometric parameters at 12 months after laparoscopic sleeve gastrectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Mihalache ◽  
Dimitrie Siriopol ◽  
Lidia Iuliana Arhire ◽  
Sergiu Pădureanu ◽  
Cristina Preda ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Body Composition ◽  
Sleeve Gastrectomy ◽  
Sleep Apnea ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Anthropometric Parameters ◽  
Obstructive Sleep ◽  
Apnea Syndrome

AbstractThe aim of this study was to assess the influence of obstructive sleep apnea syndrome (OSAS) on the change in anthropometric parameters and body composition, in patients undergoing laparoscopic sleeve gastrectomy (LSG). This prospective study included patients undergoing LSG who had pre-operative polysomnography data and were also evaluated at six and 12 months after surgery. All patients included also had whole body composition analysis data before surgery and at six and 12 months after surgery. The results are presented in comparison between patients with and without OSAS. We included 73 patients in the analysis with a mean ± SD age and body mass index (BMI) of 40.3 ± 10.9 years and 45.4 ± 6.3 kg/m2, respectively. As compared to the baseline levels, at 6 months there was a significant decrease in BMI, weight, waist circumference, serum glucose and HbA1c. At 12 months there was no further decrease as compared to the 6 months levels, irrespective of OSAS status. We observed a significant decrease at 6 months in percentage of fat, in both types of patients. However, as compared to the 6 months levels, at 12 months the percent fat had a significant decrease only in patients without OSAS (− 4.6%, 95% CI − 7.6 to − 1.7%) and not in those with OSAS (− 2.2%, 95% CI − 4.5 to 0.2%). In our study, patients with OSAS showed a similar decrease in different anthropometric parameters as those without OSAS after LSG. However, at 12 months of follow-up there was a significant decrease in the percent fat only in patients without OSAS.

Time delay of baroreflex control and oscillatory pattern of sympathetic activity in patients with metabolic syndrome and obstructive sleep apnea

2013 ◽  
Vol 304 (7) ◽  
pp. H1038-H1044 ◽  
Author(s):  
Edgar Toschi-Dias ◽  
Ivani C. Trombetta ◽  
Valdo J. Dias da Silva ◽  
Cristiane Maki-Nunes ◽  
Felipe X. Cepeda ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Time Delay ◽  
Sympathetic Activity ◽  
Apnea Hypopnea Index ◽  
Baroreflex Control ◽  
Oscillatory Pattern ◽  
Obstructive Sleep ◽  
The Impact

The incidence and strength of muscle sympathetic nerve activity (MSNA) depend on the magnitude (gain) and latency (time delay) of the arterial baroreflex control (ABR). However, the impact of metabolic syndrome (MetS) and obstructive sleep apnea (OSA) on oscillatory pattern of MSNA and time delay of the ABR of sympathetic activity is unknown. We tested the hypothesis that MetS and OSA would impair the oscillatory pattern of MSNA and the time delay of the ABR of sympathetic activity. Forty-three patients with MetS were allocated into two groups according to the presence of OSA (MetS + OSA, n = 21; and MetS − OSA, n = 22). Twelve aged-paired healthy controls (C) were also studied. OSA (apnea-hypopnea index > 15 events/h) was diagnosed by polysomnography. We recorded MSNA (microneurography), blood pressure (beat-to-beat basis), and heart rate (EKG). Oscillatory pattern of MSNA was evaluated by autoregressive spectral analysis and the ABR of MSNA (ABRMSNA, sensitivity and time delay) by bivariate autoregressive analysis. Patients with MetS + OSA had decreased oscillatory pattern of MSNA compared with MetS − OSA ( P < 0.01) and C ( P < 0.001). The sensitivity of the ABRMSNA was lower and the time delay was greater in MetS + OSA compared with MetS − OSA ( P < 0.001 and P < 0.01, respectively) and C ( P < 0.001 and P < 0.001, respectively). Patients with MetS − OSA showed decreased oscillatory pattern of MSNA compared with C ( P < 0.01). The sensitivity of the ABRMSNA was lower in MetS − OSA than in C group ( P < 0.001). In conclusion, MetS decreases the oscillatory pattern of MSNA and the magnitude of the ABRMSNA. OSA exacerbates these autonomic dysfunctions and further increases the time delay of the baroreflex response of MSNA.

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