Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Surg Obes Relat Dis. 2021 Apr;17(4):711-717. doi: 10.1016/j.soard.2020.12.003. Epub 2020 Dec 17.
Little is known regarding obstructive sleep apnea's (OSA's) prevalence or the factors related to OSA remission post-metabolic bariatric surgery (MBS) in adolescents.
To identify the baseline OSA prevalence in adolescents with severe obesity and examine factors associated with post-MBS OSA remission.
Tertiary-care children's hospital.
We conducted a retrospective chart review of 81 patients pre-MBS with OSA assessments done between June 2017 to September 2020 to collect demographic characteristics; co-morbidities; polysomnography (PSG) results, if indicated; and weight data. Chi-square or Mann-Whitney tests compared baseline characteristics and surgical outcomes by pre-MBS OSA status. McNemar's test or t tests assessed differences in baseline characteristics, stratified by remission versus no remission of OSA.
The patients were 71% female, had an average age of 16.9 ± 2.0 years, and had a mean body mass index (BMI) of 47.9 ± 7.3 kg/m. Half (50%) of the patients were Hispanic and 20% had type 2 diabetes. The OSA prevalence, defined as an Obstructive Apnea Hypopnea Index (OAHI) score ≥5, was 54% pre-MBS (n = 44), with 43% having severe OSA (OAHI > 30). Those with OSA were older (17.3 versus 16.4 yr, respectively; P = .05), more likely to be male (79% versus 42%, respectively; P = .022), and had higher baseline weights (142.0 versus 126.4 kg, respectively; P = .001) than those without OSA. Of the 23 patients with a post-MBS PSG result (average 5 mo post MBS), 15 (66%) had remission of OSA. Patients with OSA remission had a lower average pre-MBS BMI (46.0 versus 57.7 kg/m, respectively; P < .001) and weight (132.9 versus 172.6 kg, respectively; P = .002) but no significant differences in percentage weight loss through 12 months post MBS versus those with continued OSA.
The OSA prevalence in an adolescent MBS population was higher than that in the general adolescent population with severe obesity. Remission of OSA was correlated with lower pre-MBS BMI and weight, but not weight loss within the first year post-MBS.
对于青少年阻塞性睡眠呼吸暂停（OSA）的患病率或代谢性减重手术后（MBS）OSA 缓解的相关因素知之甚少。
确定严重肥胖青少年中 OSA 的基线患病率，并研究与 MBS 后 OSA 缓解相关的因素。
三级儿童医院。
我们对 2017 年 6 月至 2020 年 9 月期间进行的 81 例术前 MBS 伴 OSA 评估的严重肥胖青少年患者进行了回顾性图表审查，以收集人口统计学特征；合并症；如果需要，则进行多导睡眠图（PSG）结果；以及体重数据。通过术前 MBS 中 OSA 状态的卡方检验或曼-惠特尼检验比较基线特征和手术结果。Mcnemar 检验或 t 检验评估了根据 OSA 缓解或不缓解分层的基线特征的差异。
患者中女性占 71%，平均年龄为 16.9±2.0 岁，平均体重指数（BMI）为 47.9±7.3kg/m。一半（50%）的患者为西班牙裔，20%患有 2 型糖尿病。OSA 的患病率定义为阻塞性呼吸暂停低通气指数（OAHI）≥5，术前为 54%（n=44），其中 43%为严重 OSA（OAHI>30）。患有 OSA 的患者年龄更大（分别为 17.3 岁和 16.4 岁，P=0.05），更可能为男性（分别为 79%和 42%，P=0.022），并且基线体重更高（分别为 142.0 公斤和 126.4 公斤，P=0.001）比没有 OSA 的患者。在 23 例术后 MBS 的 PSG 结果（平均术后 5 个月）中，有 15 例（66%）患者的 OSA 缓解。OSA 缓解的患者术前 BMI（分别为 46.0 和 57.7kg/m，P<0.001）和体重（分别为 132.9 和 172.6kg，P=0.002）均较低，但与持续 OSA 相比，术后 12 个月内的体重减轻百分比无显著差异。
青少年 MBS 人群中的 OSA 患病率高于严重肥胖青少年的一般人群。OSA 的缓解与术前 BMI 和体重较低有关，但与 MBS 后第一年的体重减轻无关。
