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病态肥胖患者行 Roux-en-Y 胃旁路术伴或不伴阻塞性睡眠呼吸暂停低通气综合征的内皮功能。

Endothelial Function of Patients with Morbid Obesity Submitted to Roux-en-Y Gastric Bypass With and Without Obstructive Sleep Apnea-Hypopnea Syndrome.

机构信息

Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, Brazil.

Centro de Ciências da Saúde, Curso de Fisioterapia, Universidade Federal de Santa Maria - UFSM, Av. Roraima no. 1000, Cidade Universitária, Bairro Camobi, Santa Maria, RS, 97105-900, Brazil.

出版信息

Obes Surg. 2018 Nov;28(11):3595-3603. doi: 10.1007/s11695-018-3403-9.

DOI:10.1007/s11695-018-3403-9
PMID:30054874
Abstract

BACKGROUND

Obesity is associated with obstructive sleep apnea-hypopnea syndrome (OSA) and both induce endothelial dysfunction. However, the effect of OSA on endothelial function after bariatric surgery has not been investigated yet.

OBJECTIVES

This study aims to evaluate the impact of weight loss on endothelial function in patients with and without obstructive sleep apnea (OSA) in the first 6 months after bariatric surgery.

SETTING

This study was conducted at a university hospital, in Brazil.

METHODS

The sample consisted of 56 patients homogeneously divided into groups with and without OSA. All patients underwent Roux-en-Y gastric bypass (RYGB), and the diagnosis of OSA was performed by polysomnography. The patients were evaluated preoperatively and 6 months after surgery. The evaluations included anthropometric measures, electrical bioimpedance, clinical symptoms of OSA, and endothelial function (flow-mediated dilation). RYGB improved the anthropometric, bioimpedance, and endothelial function results in both groups.

RESULTS

Patients presented a significant clinical improvement in OSA symptoms throughout the study. However, patients with OSA had an improvement in the endothelial function 2.5% lower (p < 0.001) than patients without APNEA syndrome.

CONCLUSION

This study demonstrates that the existence of OSA prior to bariatric surgery interferes in the improvement of endothelial function.

摘要

背景

肥胖与阻塞性睡眠呼吸暂停低通气综合征(OSA)有关,两者均会导致内皮功能障碍。然而,肥胖症患者接受减重手术后对内皮功能的影响尚未得到研究。

目的

本研究旨在评估减重手术后前 6 个月,OSA 患者和非 OSA 患者的体重减轻对内皮功能的影响。

设置

本研究在巴西的一所大学医院进行。

方法

该样本由 56 名患者组成,分为 OSA 组和非 OSA 组。所有患者均接受 Roux-en-Y 胃旁路术(RYGB),通过多导睡眠图诊断 OSA。患者在术前和术后 6 个月接受评估。评估包括人体测量指标、电生物阻抗、OSA 的临床症状和内皮功能(血流介导的扩张)。RYGB 改善了两组的人体测量、生物阻抗和内皮功能结果。

结果

患者在整个研究过程中 OSA 症状均有显著改善。然而,与无 APNEA 综合征的患者相比,患有 OSA 的患者内皮功能改善低 2.5%(p < 0.001)。

结论

本研究表明,肥胖症患者在接受减重手术前存在 OSA 会干扰内皮功能的改善。

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