The Prevalence and Predictors of Obstructive Sleep Apnea in Chinese Bariatric Surgery Candidates: A Single-Center Study

Abstract

Purpose: The purpose of the study is to determine the prevalence and predictors of OSA in Chinese bariatric surgery candidates.

Materials and methods: The clinical data were collected from 326 patients evaluated for bariatric surgery and referred for polysomnography. Multiple logistic regression was used for identifying independent predictors of presence of OSA and ROC curve analysis to determine the best cut-off value for continuous variable.

Results: Baseline BMI and age were 33.3±3.7 kg/m² and 24.3±3.1 years. 62.9% of the patients fulfilled the diagnostic criteria for OSA; Of these, 22.7% had mild OSA; 11.3% had moderate OSA, and 28.8% had severe OSA. The prevalence was significantly higher in males (84.2%) than in females (47.3%) (P<0.001). The superobese patients and the obese patients aged older than 50 years that all of those were diagnosed with OSA. A multivariate logistic regression model displayed that increasing age, BMI and neck circumference together with presence of habitual snoring and male sex were identified as risk factors of OSA. The best cut-off values for the presence of OSA for age, BMI, neck circumference were 24.5 years, 39.45 kg/m², 40.40 cm.

Conclusion: The prevalence of OSA is very prevalent (62.9%) in Chinese bariatric surgery candidates, especially in male patients (84%). Age, BMI and neck circumference together with presence of habitual snoring and male sex are independent predictors of OSA in these patients. As clinical predictors are not enough to be a properly screening for OSA, routine PSG testing should be recommended to bariatric surgery candidates.

Keywords: Bariatric surgery; Obesity; Obstructive sleep apnea.

Fig. 1. Distribution of the OSA prevalence by sex, age, BMI.

Fig. 2. (A) ROC curve comparing sensitivity and specificity of age, body mass index (BMI) and neck circumference of an AHI ≥5. The mean area under the curve (AUC) for age, BMI and neck circumference were 0.702 (95% CI 0.643–0.760), 0.751 (95% CI 0.699–0.804), 0.791 (95% CI 0.741–0.840), respectively. (B) ROC curve comparing sensitivity and specificity of age, body mass index (BMI) and neck circumference of an AHI ≥15. The mean area under the curve (AUC) for age, BMI and neck circumference were 0.663 (95% CI 0.604–0.723), 0.747 (95% CI 0.693–0.801), 0.832 (95% CI 0.787–0.877), respectively.