Impact of surgical intervention on obstructive sleep apnea (OSA) and body-mass index: a scoping review.

Liang Chye Goh, Ein Wan Chin, Benjamin Kye Jyn Tan, Esther Yanxin Gao, Sheron Sir Loon Goh, Ranita Hisham Shunmugam, Jeyanthi Kulasegarah, Mohd Zulkiflee Abu Bakar, Song Tar Toh
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Abstract

Background: Upper airway surgery for obstructive sleep apnea (OSA) offers an alternative to CPAP, but its impact on weight changes is poorly studied.

Purpose: To systematically review published literature on the relationship between surgical intervention for OSA and changes in body mass index (BMI).

Methods: A literature search was conducted from 2013-2024 in five databases. Full-text English articles which examined BMI changes in adults with OSA pre- and post-surgery were included. The quality of each study was assessed independently by two researchers using the Newcastle-Ottawa Scale. This study was reported according to the PRISMA-ScR.

Results: Eleven studies, involving 406 patients from six countries were included. Most patients were males (88.4%) with a mean age of 40 years old. The pre-operative BMI were higher [27.8 kg/m2 (SD = 2.6)] compared to a BMI of 27.7 kg/m2 (SD = 1.3) at 21.0 months post-operation. The pre-operative Epworth Sleepiness Score was 13.28 (SD = 6.36), while the apnea-hypopnea index was 41.2 (SD = 16.88), indicating that most patients were diagnosed with severe OSA. The average oxygen desaturation index was 35.63 (SD = 11.17). The meta-analysis showed no significant BMI changes after surgery (mean difference:-0.29; 95% CI:-0.80 to 0.21; I2 = 30%). Findings were consistent with no publication bias found.

Conclusions: Upper airway surgery for OSA does not significantly affect BMI. The authors propose closer monitoring of weight changes following upper airway surgery, as weight fluctuations can impact the outcomes of surgery. Unchanged weight post-surgery may be attributed to suboptimal OSA treatment.

手术干预对阻塞性睡眠呼吸暂停(OSA)和身体质量指数的影响:范围综述。
背景:阻塞性睡眠呼吸暂停(OSA)的上呼吸道手术提供了CPAP的替代方案,但其对体重变化的影响研究甚少。目的:系统回顾OSA手术干预与体重指数(BMI)变化关系的已发表文献。方法:检索2013-2024年5个数据库的文献。纳入了研究OSA成人患者手术前后BMI变化的全文英文文章。每项研究的质量由两名研究人员使用纽卡斯尔-渥太华量表独立评估。本研究是根据PRISMA-ScR报告的。结果:纳入了11项研究,涉及6个国家的406例患者。患者以男性为主(88.4%),平均年龄40岁。术前BMI为27.8 kg/m2 (SD = 2.6),术后21.0个月BMI为27.7 kg/m2 (SD = 1.3)。术前Epworth嗜睡评分为13.28 (SD = 6.36),呼吸暂停低通气指数为41.2 (SD = 16.88),多数患者诊断为重度OSA。平均氧去饱和指数为35.63 (SD = 11.17)。meta分析显示,手术后BMI无显著变化(平均差值:-0.29;95% CI:-0.80 ~ 0.21;i2 = 30%)。研究结果与未发现发表偏倚一致。结论:阻塞性睡眠呼吸暂停的上呼吸道手术对BMI无显著影响。作者建议密切监测上呼吸道手术后的体重变化,因为体重波动会影响手术结果。术后体重不变可能归因于不理想的OSA治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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