Roux-en-Y Gastric Bypass Surgery on Obstructive Sleep Apnea-Hypopnea Syndrome: Factors Associated with Postoperative Efficacy

Abstract

Background: Bariatric surgery can effectively treat obesity and improve OSAHS. However, the exact underlying mechanisms remain unclear. The objective of this follow-up study is to explore the main factors associated with the efficacy of Roux-en-Y gastric bypass surgery (RYGB) on obstructive sleep apnea-hypopnea syndrome (OSAHS).

Methods: A total of 39 OSAHS patients with obesity and type 2 diabetes mellitus (T2DM) who had received RYGB surgery were recruited. A polysomnography test was carried out in all subjects before surgery and postoperative 6 to 12 months, and the following tests were performed: fasting glucose, lipid profile, electrolyte levels, and liver and kidney function tests. The paired Student's t test, Pearson test, Spearman correlation test, and multiple linear regression analysis were used to explore the effects of RYGB surgery on these indices and investigate the main factors associated with postoperative efficacy.

Results: RYGB surgery significantly lowered the apnea-hypopnea index (AHI), body mass index (BMI), and concentrations of total albumin, prealbumin, retinol-binding protein, total cholesterol, triglycerides, fasting blood glucose, albumin, and C-reactive protein, while postoperative blood magnesium levels were significantly increased (p < 0.05). Changes in the AHI (delta AHI) were correlated with delta BMI (r = 0.408, p = 0.010) and delta prealbumin levels (r = 0.495, p = 0.001). However, no significant correlation was found between delta BMI and delta prealbumin. The delta AHI were assessed by multiple linear analysis as follows: delta AHI = 0.105 × (delta prealbumin) + 1.509 × (delta BMI) + 1.006.

Conclusions: RYGB is an effective therapeutic option for OSAHS patients with obesity and T2DM; the potential factors associated with postoperative efficacy include changes in BMI and prealbumin levels.

Keywords: Bariatric surgery; Diabetes mellitus; Obesity; Obstructive sleep apnea–hypopnea syndrome; Prealbumin.