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Bariatric Surgery

Bariatric surgery short-term outcomes in patients with obstructive sleep apnoea: the Severe Obesity Outcome Network prospective cohort

International Journal of Obesity volume 45, pages 2388–2395 (2021)Cite this article

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Abstract

Background/objectives

Although the benefits of bariatric surgery have been clearly established, it is not known whether they are as important in patients with obstructive sleep apnoea (OSA). Primary aim: to evaluate whether patients with moderate-to-severe OSA (apnoea-hypopnea index (AHI) ≥ 15 events/h) treated by continuous positive airway pressure/non-invasive ventilation (median [IQR] adherence 6.5 h/night [5; 7.9] at baseline) lose the same amount of body weight 1 year after bariatric surgery as patients with no or mild OSA. Secondary objectives: to compare the evolution of type 2 diabetes and hypertension after bariatric surgery, and surgical complication rates between groups.

Methods/subjects

Analyses were performed in 371 patients included in a prospective cohort of bariatric surgery, the Severe Obesity Outcome Network cohort. Subjects having moderate-to-severe OSA (n = 210) at baseline were compared with other subjects (n = 161).

Results

Excess weight loss (%EWL) at 1 year was lower in patients with moderate-to-severe OSA than in patients without (64.9%EWL [46.9; 79.5] vs. 73.8%EWL [56.6; 89.3], p < 0.01). Multivariable analysis showed that age, initial body mass index and type of surgery, but not OSA status, were associated with 1-year %EWL. Diabetes remitted in 25 (41%) patients with moderate-to-severe OSA and 16 (48%) patients with no or mild OSA (p = 0.48). Hypertension remitted in 28 (32.9%) patients with moderate-to-severe OSA and 9 (40.9%) with no or mild (p = 0.48). Complication rates were 28 (13.3%) in patients with moderate-to-severe OSA and 12 (7.5%) in patients with no or mild OSA (p = 0.07).

Conclusions

Patients with OSA lose less body weight after bariatric surgery. This was related to older age and a higher baseline body mass index. However, the improvements of diabetes and hypertension were similar to that of patients without OSA, and the risk of surgical complications was not higher.

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Fig. 1: Flow chart.
Fig. 2: Percent of excess weight loss 1 year after bariatric surgery in patients with severe obstructive sleep apnoea compared to other patients.

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Acknowledgements

We wish to thank M’Barka Daoukhi, clinical research assistant for the SOON cohort. We also wish to thank Johanna Robertson for English editing. The SOON cohort is supported by the foundation ‘Agir pour les maladies chroniques’, the ‘Agence Régionale pour la Santé Rhône-Alpes’, France and the ‘Direction de la recherche clinique et de l’innovation’ of the University hospital Grenoble Alpes, France. J-LP and RT are supported by the French National Research Agency in the framework of the ‘Investissements d’avenir’ program (ANR-15-IDEX-02) and the ‘e-health and integrated care and trajectories medicine and MIAI artificial intelligence’ Chairs of excellence from the Grenoble Alpes University Foundation. This work was partially supported by MIAI @ Grenoble Alpes, (ANR-19-P3IA-0003).

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Authors and Affiliations

  1. Department of Endocrinology Diabetology Nutrition, Grenoble Alpes University Hospital, Centre Spécialisé de l’Obésité Grenoble Arc Alpin, Grenoble, France

    Jessica Guggino, Sandrine Coumes & Nelly Wion

  2. Univ. Grenoble Alpes, Inserm, U1300, “Hypoxia-physiopathology” Laboratory, Grenoble Alpes University Hospital, “Pôle Thorax et Vaisseaux”, Grenoble, France

    Renaud Tamisier & Jean-Louis Pépin

  3. Univ. Grenoble Alpes, “Translational Innovation in Medicine and Complexity” (TIMC) Laboratory, Department of Endocrinology Diabetology Nutrition, Grenoble Alpes University Hospital, Grenoble, France

    Cécile Betry

  4. Univ. Grenoble Alpes, Department of Digestive Surgery, Grenoble Alpes University Hospital, Grenoble, France

    Catherine Arvieux

  5. Univ. Grenoble Alpes, “Translational Innovation in Medicine and Complexity” (TIMC) Laboratory, Department of Digestive Surgery, Grenoble Alpes University Hospital, Grenoble, France

    Fabian Reche

  6. Univ. Grenoble Alpes, Inserm, U1300, “Hypoxia-physiopathology” Laboratory, Department of Endocrinology Diabetology Nutrition, Grenoble Alpes University Hospital, Centre Spécialisé de l’Obésité Grenoble Arc Alpin, Grenoble, France

    Anne-Laure Borel

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Contributions

JG collected data and analysed results. RT, CB, SC, CA, NW, FR, and JLP reviewed the paper for important intellectual content. ALB is responsible of the SOON cohort, conceived the study design, analysed data and written the paper.

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Correspondence to Anne-Laure Borel.

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Competing interests

RT reports grants and personal fees from Resmed, personal fees from Navigant, personal fees from Jazz Pharmaceutical, personal fees and non-financial support from Agiradom, grants and personal fees from Philips, personal fees from Elivie, grants from Vitlair, grants from ‘Agir pour les maladies chroniques’ foundation, during the conduct of the study; J-LP reports grants from Resmed, personal fees from Navigant, personal fees from Air liquide foundation, grants and personal fees from Agiradom, grants and personal fees from Philips, grants from Astra zaneka, grants from Vitalair, grants from ‘Agir pour les maladies chroniques’ foundaiton, personal fees from Jazz pharmaceutical, personal fees from Night balance, grants from Fisher and paykel, grants from Mutualia, personal fees from Boehringer Ingelheim, grants from Sefam, during the conduct of the study. A-LB reports personal fees from Agiradom, personal fees and non-financial support from Vitalair, grants from ‘Agir pour les maladies chroniques’ foundation, during the conduct of the study. The other authors declare no competing interests.

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Guggino, J., Tamisier, R., Betry, C. et al. Bariatric surgery short-term outcomes in patients with obstructive sleep apnoea: the Severe Obesity Outcome Network prospective cohort. Int J Obes 45, 2388–2395 (2021). https://doi.org/10.1038/s41366-021-00903-5

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