Obstructive sleep apnea and early weight loss among adolescents undergoing bariatric surgery.
Obstructive sleep apnea and early weight loss among adolescents undergoing bariatric surgery.
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DOI：
10.1016/j.soard.2020.12.003
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Simon SL
中科院分区：
文献类型：
--
作者：
Kaar JL;Morelli N;Russell SP;Talker I;Moore JM;Inge TH;Nadeau KJ;Hawkins SMM;Aloia MS;Simon SL
关于青少年代谢减肥手术（MBS）后阻塞性睡眠呼吸暂停（OSA）的患病率或与OSA缓解相关的因素知之甚少。确定重度肥胖青少年的基线OSA患病率，并检查与mbs后OSA缓解相关的因素。三级儿童医院。我们对2017年6月至2020年9月期间进行OSA评估的81例mbs前患者进行了回顾性图表回顾，以收集人口统计学特征；并发症;如有提示，多导睡眠图（PSG）结果；还有体重数据。卡方检验或曼-惠特尼检验比较了mbs前OSA状态的基线特征和手术结果。McNemar检验或t检验评估基线特征的差异，按OSA缓解与无缓解进行分层。患者女性占71%，平均年龄16.9±2.0岁，平均体重指数（BMI） 47.9±7.3 kg/m2。一半（50%）的患者是西班牙裔，20%患有2型糖尿病。以阻塞性呼吸暂停低通气指数（OAHI）评分≥5定义的OSA患病率在mbs前为54% (n = 44)，其中43%患有严重OSA （OAHI bbb30）。OSA患者年龄较大（分别为17.3岁和16.4岁，P = 0.05），男性患病率较高（分别为79%和42%，P = 0.022），基线体重较高（分别为142.0和126.4公斤，P = 0.001）。在23例MBS后PSG结果（MBS后平均5个月）的患者中，15例（66%）OSA缓解。OSA缓解患者的MBS前平均BMI（分别为46.0和57.7 kg/m2, P < 0.001）和体重（分别为132.9和172.6 kg, P = 0.002）较低，但MBS后12个月的体重减轻百分比与持续OSA患者无显著差异。青少年MBS人群的OSA患病率高于一般重度肥胖青少年人群。OSA的缓解与mbs前较低的BMI和体重相关，但与mbs后第一年的体重减轻无关。（外科学杂志2021；17:711-717。）
Little is known regarding obstructive sleep apnea’s (OSA’s) prevalence or the factors related to OSA remission post–metabolic bariatric surgery (MBS) in adolescents. To identify the baseline OSA prevalence in adolescents with severe obesity and examine factors associated with post-MBS OSA remission. Tertiary-care children’s hospital. We conducted a retrospective chart review of 81 patients pre-MBS with OSA assessments done between June 2017 to September 2020 to collect demographic characteristics; co-morbidities; polysomnography (PSG) results, if indicated; and weight data. Chi-square or Mann-Whitney tests compared baseline characteristics and surgical outcomes by pre-MBS OSA status. McNemar’s test or t tests assessed differences in baseline characteristics, stratified by remission versus no remission of OSA. The patients were 71% female, had an average age of 16.9 ± 2.0 years, and had a mean body mass index (BMI) of 47.9 ± 7.3 kg/m2. Half (50%) of the patients were Hispanic and 20% had type 2 diabetes. The OSA prevalence, defined as an Obstructive Apnea Hypopnea Index (OAHI) score ≥5, was 54% pre-MBS (n = 44), with 43% having severe OSA (OAHI > 30). Those with OSA were older (17.3 versus 16.4 yr, respectively; P = .05), more likely to be male (79% versus 42%, respectively; P = .022), and had higher baseline weights (142.0 versus 126.4 kg, respectively; P = .001) than those without OSA. Of the 23 patients with a post-MBS PSG result (average 5 mo post MBS), 15 (66%) had remission of OSA. Patients with OSA remission had a lower average pre-MBS BMI (46.0 versus 57.7 kg/m2, respectively; P < .001) and weight (132.9 versus 172.6 kg, respectively; P = .002) but no significant differences in percentage weight loss through 12 months post MBS versus those with continued OSA. The OSA prevalence in an adolescent MBS population was higher than that in the general adolescent population with severe obesity. Remission of OSA was correlated with lower pre-MBS BMI and weight, but not weight loss within the first year post-MBS. (Surg Obes Relat Dis 2021;17:711–717.)
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