Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, No. 127, Siyuan Rd., Xinzhuang Dist., New Taipei City, Taiwan.
Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan.
Eur Arch Otorhinolaryngol. 2022 Aug;279(8):3811-3820. doi: 10.1007/s00405-022-07382-y. Epub 2022 May 15.
The effects of sleep surgery on the lipid profile of adults diagnosed as having obstructive sleep apnea (OSA) remain unclear. This meta-analysis aimed to clarify whether sleep surgeries improve patients' lipid profile.
The study protocol was registered on PROSPERO (CRD42020154425). Two authors independently searched the PubMed, MEDLINE, EMBASE, and Cochrane review databases up to September 2020 using keywords such as sleep apnea, OSA, sleep apnea syndromes, lipids, and surgery. The effects of sleep surgery on the apnea-hypopnea index (AHI) and lipid profile parameters were evaluated using a random-effects model.
Thirteen studies were included, with a total of 710 patients (mean age: 42.0 years; 85% men; mean sample size: 54.6 patients). The summary estimate of AHI change was - 20.6 events/h (95% CI - 25.9 to - 15.3) and the Epworth Sleepiness Scale score was - 4.2 (95% CI - 5.9 to - 2.5). Sleep surgery lowered total cholesterol (mean - 7.7 mg/dL; 95% CI - 12.2 to - 3.2), low-density lipoprotein (mean - 7.2 mg/dL; 95% CI - 11.0 to - 3.3), and triglyceride (mean - 14.0 mg/dL; 95% CI - 22.2 to - 5.8) levels but did not affect high-density lipoprotein (mean 1.5 mg/dL; 95% CI - 0.6 to 3.7) levels. Subgroup analysis revealed that the lipid profile changes were not associated with the surgical procedure but with the degree of OSA improvement. Meta-regression analyses demonstrated that the improvement in the lipid profile was positively correlated with AHI reduction.
Surgeries for OSA may improve the lipid profile, which is positively correlated with the degree of OSA improvement.
睡眠手术对被诊断为阻塞性睡眠呼吸暂停（OSA）的成年人的血脂谱的影响尚不清楚。本荟萃分析旨在阐明睡眠手术是否能改善患者的血脂谱。
研究方案已在 PROSPERO（CRD42020154425）上注册。两位作者独立检索了 PubMed、MEDLINE、EMBASE 和 Cochrane 综述数据库，截至 2020 年 9 月，使用了“睡眠呼吸暂停”、“OSA”、“睡眠呼吸暂停综合征”、“脂质”和“手术”等关键词。使用随机效应模型评估睡眠手术对呼吸暂停-低通气指数（AHI）和血脂谱参数的影响。
共纳入 13 项研究，共 710 例患者（平均年龄：42.0 岁；85%为男性；平均样本量：54.6 例）。AHI 变化的汇总估计值为-20.6 次/小时（95%可信区间：-25.9 至-15.3），Epworth 睡眠量表评分为-4.2（95%可信区间：-5.9 至-2.5）。睡眠手术降低了总胆固醇（平均-7.7mg/dL；95%可信区间：-12.2 至-3.2）、低密度脂蛋白（平均-7.2mg/dL；95%可信区间：-11.0 至-3.3）和甘油三酯（平均-14.0mg/dL；95%可信区间：-22.2 至-5.8）水平，但对高密度脂蛋白（平均 1.5mg/dL；95%可信区间：-0.6 至 3.7）水平没有影响。亚组分析显示，血脂谱的变化与手术方式无关，而与 OSA 改善程度有关。Meta 回归分析表明，血脂谱的改善与 AHI 的降低呈正相关。
OSA 的手术治疗可能改善血脂谱，且与 OSA 改善程度呈正相关。
