Sleep apnoea patients lose less body weight after bariatric surgery, reports Study
Although the benefits of bariatric surgery have been clearly established, it is not known whether they are as important in patients with obstructive sleep apnoea (OSA). A recent report published in the International Journal of Obesity states that patients with obstructive sleep apnoea lose less body weight after bariatric surgery and that it is related to older age and a higher baseline body mass index.
Jessica Guggino and colleagues from the Department of Endocrinology Diabetology Nutrition, Grenoble Alpes University Hospital, Centre Spécialisé de l'Obésité Grenoble Arc Alpin, Grenoble, France conducted the study with the aim to evaluate whether patients with moderate-to-severe obstructive sleep apnoea treated by continuous positive airway pressure/non-invasive ventilation lose the same amount of body weight 1 year after bariatric surgery as patients with no or mild obstructive sleep apnoea.
Secondary objectives were laid out to compare the evolution of type 2 diabetes and hypertension after bariatric surgery, and surgical complication rates between groups.
Analyses were performed in 371 patients included in a prospective cohort of bariatric surgery, the Severe Obesity Outcome Network cohort. Subjects having moderate-to-severe obstructive sleep apnoea (n = 210) at baseline were compared with other subjects (n = 161).
The following findings were highlighted-
- Excess weight loss (%EWL) at 1 year was lower in patients with moderate-to-severe obstructive sleep apnoea than in patients without (64.9%EWL [46.9; 79.5] vs. 73.8%EWL [56.6; 89.3], p < 0.01).
- Multivariable analysis showed that age, initial body mass index and type of surgery, but not obstructive sleep apnoea status, were associated with 1-year %EWL.
- Diabetes remitted in 25 (41%) patients with moderate-to-severe obstructive sleep apnoea and 16 (48%) patients with no or mild obstructive sleep apnoea (p = 0.48).
- Hypertension remitted in 28 (32.9%) patients with moderate-to-severe obstructive sleep apnoea and 9 (40.9%) with no or mild (p = 0.48).
- Complication rates were 28 (13.3%) in patients with moderate-to-severe obstructive sleep apnoea and 12 (7.5%) in patients with no or mild obstructive sleep apnoea (p = 0.07).
As a result, it was concluded that patients with obstructive sleep apnoea lose less body weight after bariatric surgery. This was related to older age and a higher baseline body mass index.
However, the improvements of diabetes and hypertension were similar to that of patients without obstructive sleep apnoea, and the risk of surgical complications was not higher.
Guggino, J., Tamisier, R., Betry, C. et al. Bariatric surgery short-term outcomes in patients with obstructive sleep apnoea: the Severe Obesity Outcome Network prospective cohort. Int J Obes (2021). https://doi.org/10.1038/s41366-021-00903-5
