Department of Otolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (mainland).
Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland).
Med Sci Monit. 2014 Dec 13;20:2651-7. doi: 10.12659/MSM.892230.
Obstructive sleep apnea (OSA) is tightly linked to increased cardiovascular disease. Surgery is an important method to treat OSA, but its effect on serum lipid levels in OSA patients is unknown. We aimed to evaluate the effect of upper airway surgery on lipid profiles.
We performed a retrospective review of 113 adult patients with OSA who underwent surgery (nasal or uvulopalatopharyngoplasty [UPPP]) at a major, urban, academic hospital in Beijing from 2012 to 2013 who had preoperative and postoperative serum lipid profiles.
Serum TC (4.86±0.74 to 4.69±0.71) and LP(a) (median 18.50 to 10.90) all decreased significantly post-operatively (P<0.01, 0.01, respectively), with no changes in serum HDL, LDL, or TG (P>0.05, all). For UPPP patients (n=51), serum TC, HDL and LP(a) improved (P=0.01, 0.01,<0.01, respectively). For nasal patients (n=62), only the serum LP(a) decreased (P<0.01). In patients with normal serum lipids at baseline, only serum LP(a) decreased (P<0.01). In contrast, in patients with isolated hypertriglyceridemia, the serum HDL, TG and LP(a) showed significant improvements (P=0.02, 0.03, <0.01, respectively). In patients with isolated hypercholesterolemia, the serum LP(a) decreased significantly (P=0.01), with a similar trend for serum TC (P=0.06). In patients with mixed hyperlipidemia, the serum TC and LDL also decreased (P=0.02, 0.03, respectively).
Surgery may improve blood lipid levels in patients with OSA, especially in patients with preoperative dyslipidemia, potentially yielding a major benefit in metabolism and cardiovascular sequelae. Prospective studies should examine this potential metabolic effect of airway surgery for OSA.
阻塞性睡眠呼吸暂停（OSA）与心血管疾病的风险增加密切相关。手术是治疗 OSA 的重要方法，但它对 OSA 患者血清脂质水平的影响尚不清楚。我们旨在评估上气道手术对血脂谱的影响。
我们对 2012 年至 2013 年在北京一家主要的城市学术医院接受手术（鼻或悬雍垂腭咽成形术[UPPP]）的 113 例 OSA 成年患者进行了回顾性研究，这些患者术前和术后均有血清脂质谱。
术后血清总胆固醇（TC）（中位数 4.86±0.74 至 4.69±0.71）和脂蛋白（a）[LP(a)]（中位数 18.50 至 10.90）均显著降低（P<0.01，0.01，分别），而血清高密度脂蛋白（HDL）、低密度脂蛋白（LDL）或甘油三酯（TG）无变化（P>0.05，均）。对于 UPPP 患者（n=51），血清 TC、HDL 和 LP(a) 改善（P=0.01，0.01，<0.01，分别）。对于鼻患者（n=62），仅血清 LP(a)降低（P<0.01）。在基线时血清脂质正常的患者中，仅血清 LP(a)降低（P<0.01）。相比之下，在孤立性高甘油三酯血症患者中，血清 HDL、TG 和 LP(a)显著改善（P=0.02，0.03，<0.01，分别）。在孤立性高胆固醇血症患者中，血清 LP(a)显著降低（P=0.01），血清 TC 也有类似的趋势（P=0.06）。在混合性高脂血症患者中，血清 TC 和 LDL 也降低（P=0.02，0.03，分别）。
手术可能改善 OSA 患者的血脂水平，特别是术前血脂异常的患者，可能对代谢和心血管后遗症有重要益处。应进行前瞻性研究，以检查气道手术对 OSA 的这种潜在代谢作用。
