Association of Metabolic Syndrome With Prevalence of Obstructive Sleep Apnea and Remission After Sleeve Gastrectomy.
Association of Metabolic Syndrome With Prevalence of Obstructive Sleep Apnea and Remission After Sleeve Gastrectomy.
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代谢综合征与阻塞性睡眠呼吸暂停患病率和袖状胃切除术后缓解的关系
DOI：
10.3389/fphys.2021.650260
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发表时间：
2021
影响因子：
4
通讯作者：
Hong J
中科院分区：
文献类型：
--
作者：
Chen Y;Chen L;Ye L;Jin J;Sun Y;Zhang L;Zhao S;Zhang Y;Wang W;Gu W;Hong J
肥胖是代谢综合征和阻塞性睡眠呼吸暂停（OSA）的重要危险因素。减肥手术已被证明可以有效降低体重和肥胖相关的合并症。然而，不同基线代谢状态的肥胖患者中OSA的患病率和严重程度以及减肥手术后OSA的改善情况仍然未知。本研究的主要目的是确定中国年轻肥胖患者不同代谢状态下OSA的患病率，并评估腹腔镜袖状胃切除术后OSA的缓解情况。我们首先进行了一项横断面研究，涉及123名代谢健康的肥胖患者和200名代谢不健康的肥胖患者（年龄和BMI范围相同），以估计基线时OSA的患病率。然后，我们对67例接受腹腔镜袖状胃切除术的患者进行了一项回顾性研究，该研究在ClinicalTrials.gov上注册（参考NCT 02653430），以评价OSA的缓解情况。代谢健康和不健康肥胖患者的呼吸暂停低通气指数水平（16.6 ± 22.0 vs. 16.7 ± 18.7事件/h，P = 0.512）和OSA患病率（66.7% vs. 69.0%，P = 0.662）相似。男性、年龄、腰围、肝脾比值低是OSA的独立危险因素。腹腔镜袖状胃切除术后，体重指数（BMI）变化（10.8 ± 4.8 vs. 10.8 ± 3.0 kg/m2，P = 0.996）或呼吸暂停低通气指数（18.9 ± 24.6 vs. 17.0 ± 24.0事件/h，P = 0.800）的降低无差异。在MHO（36.3%; 54.5- 18.2%，P = 0.125）和MUO（32.2%; 66.1- 33.9%，P = 0.001）患者中观察到中重度OSA缓解。这些结果表明，在肥胖患者中，代谢综合征不会增加OSA患病率或严重程度的额外风险。代谢健康和不健康的肥胖患者在体重减轻和阻塞性睡眠呼吸暂停缓解方面都可以从腹腔镜袖状胃切除术中获益。
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.
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