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3 . 2021

The impact of a significantly reduced body mass index on the severity of obstructive sleep apnea syndrome in obese patients after bariatric surgery

Abstract

The aim of the study was to explore the relationship between obstructive sleep apnea/hypopnea syndrome (OSAHS) and the decrease of body mass index (BMI) in obese patients after bariatric surgery.

Material and methods. The prospective cohort study involved 41 patients. Inclusion criteria: BMI ≥35 kg/m2, body weight less than 200 kg, Obstructive Sleep Apnea-Hypopnea Syndrome, with a history of bariatric surgery - laparoscopic longitudinal gastrectomy (sleeve gastroplasty). Statistical data processing was carried out using nonparametric statistics methods.

Results and discussion. Polysomnography and cardiorespiratory monitoring showed that bariatric surgery led to a less severe OSAHS in all patients; apnea-hypopnea index (AHI) after surgery was 8.7±9.0 [5.6 (3.1; 12)] (p<0.001) in average and AHI was below 5 (44%) in 17 patients.

Conclusions. Bariatric surgery significantly reduces the severity of obstructive sleep apnea syndrome due to a decrease in BMI, and AHI may fully return to normal values.

Keywords:obesity, obstructive sleep apnea syndrome, bariatric surgery

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Belozerova N.V., Buniatian M.S., Rogova L.A., Yakhyaev K.A., Yurasov A.V., Gorokhova S.G. The impact of a significantly reduced body mass index on the severity of obstructive sleep apnea syndrome in obese patients after bariatric surgery. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2021; 10 (3): 38-45. DOI: https://doi.org/10.33029/2304-9529-2021-10-3-38-45 (in Russian)

REFERENCES

1. Hamilton G.S., Joosten S.A. Obstructive sleep apnoea and obesity. Aust Fam Physician. 2017; 46 (7): 460-3. PMID: 28697288.

2. Zamarron C., Valdes Cuadrado L., Alvarez-Sala R. Pathophysiologic mechanisms of cardiovascular disease in obstructive sleep apnea syndrome. Pulm Med. 2013; 2013: 521087. DOI: https://doi.org/10.1155/2013/521087 PMID: 23936649; PMCID: PMC 3712227.

3. Kovalzon V.M. Fundamentals of somnology: physiology and neurochemistry of the wake-sleep cycle. Moscow: BINOM. Laboratoriya znaniy, 2012: 239 p. (in Russian)

4. Heinzer R., Vat S., Marques-Vidal P, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015; 3 (4): 310-8.

5. Kuvat N., Tanriverdi H., Armutcu F. The relationship between obstructive sleep apnea syndrome and obesity: a new perspective on the pathogenesis in terms of organ crosstalk. Clin Respir J. 2020; 14 (7): 595-604. DOI: https://doi.org/10.1111/crj.13175 PMID: 32112481.

6. Dedov I.I., Shestakova M.V., Melnichenko G.A., et al. Interdisciplinary Clinical Practice Guidelines «Management of obesity and its comorbidities». Ozhirenie i metabolism [Obesity and Metabolism]. 2021; 18 (1): 5-99. DOI: https://doi.org/10.14341/omet12714 (in Russian)

7. Kashchenko V.A., Strizheletskiy V.V., Neimark A.E. et al. Bariatric surgery: educational and methodical manual. Saint Petersburg, 2020: 48 p. (in Russian)

8. Di Lorenzo N., Antoniou S.A., Batterham R.L., et al. Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP. Surg Endosc. 2020; 34 (6): 2332-58. DOI: https://doi.org/10.1007/s00464-020-07555-y PMCID: PMC 7214495 PMID: 32328827.

9. Polymeris A. The pluses and minuses of bariatric surgery for morbid obesity: an endocrinological perspective. Hormones (Athens). 2012; 11 (3): 233-40. DOI: https://doi.org/10.14310/horm.2002.1353 PMID: 22908056.

10. Buzunov R.V. Recommendations of the Russian Society of Somnolo-gists. 2018. (in Russian)

11. Sateia M.J. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014; 146 (5): 1387-94. DOI: https://doi.org/10.1378/chest.14-0970 PMID: 25367475.

12. Arterburn D.E., Telem D.A., Kushner R.F., et al. Benefits and risks of bariatric surgery in adults: a review. JAMA. 2020; 324 (9): 879-87. DO: https://doi.org/10.1001/jama.2020.12567 PMID: 32870301.

13. Buchwald H., Avidor Y., Braunwald E., et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004; 292: 1724-37.

14. Dixon J.B., Schachter L.M., O’Brien P.E. Polysomnography before and after weight loss in obese patients with severe sleep apnea. Int J Obes (Lond). 2005; 29: 1048-54.

15. Haines K.L., Nelson L.G., Gonzalez R., et al. Objective evidence that bariatric surgery improves obesity-related obstructive sleep apnea. Surgery. 2007; 141: 354-8.

16. Collen J., Lettieri C.J., Eliasson A. Postoperative CPAP use impacts long-term weight loss following bariatric surgery. J Clin Sleep Med. 2015; 11 (3): 213-7.

17. Wiggins T., Guidozzi N., Welbourn R., et al. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: a systematic review and meta-analysis. PLoS Med. 2020; 17 (7): e1003206. DOI: https://doi.org/10.1371/journal.pmed.1003206 PMID: 32722673; PMCID: PMC 7386646.

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CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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