scholarly journals Outcomes of Weight Loss, Diabetes, Hypertension and Obstructive Sleep Apnoea after Bariatric Surgery in Patients with Super Morbid Obesity

2020 ◽  
pp. 1-4
Author(s):  
Abdulmenem Abualsel ◽  
Abdulmenem Abualsel ◽  
Ashish Mhatre ◽  
Nalin Mathur ◽  
Susan Dovey
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Body Mass ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Super Morbid Obesity ◽  
Obstructive Sleep

Introduction: There is currently a high prevalence of obesity in the Arabian Gulf yet relatively little research on bariatric surgery. In this study we investigate the efficacy of bariatric surgery in patients with super morbid obesity, defined as a Body Mass Index (BMI) of ≥ 50 kg/m2 . Methods: All records of bariatric surgery at a single centre were examined. Outcomes measured include Body Mass Index (BMI), percentage Excess Weight Loss (%EWL), Obstructive Sleep Apnoea (OSA), Hypertension (HTN) and Type 2 Diabetes Mellitus (T2DM). Statistical relationships between %EWL against age, type of surgery and gender were analysed. Results: 144 patients were found to meet the inclusion criteria. Mean pre-operative BMI was 56.9 ± 6.1 kg/m2 . 90 (62.5%) patients underwent sleeve gastrectomy, 24 (16.7%) had one anastomosis gastric bypass, 16 (11.1%) had biliopancreatic diversion (Scopinaro’s procedure), and 14 (9.7%) had sleeve gastrectomy with transit loop bipartition. 12 months post-operatively, mean BMI was 37.7 ± 7.5 kg/m2 , with a mean %EWL of 62.9% ± 17.9%. There was 100% OSA resolution, 95.3% HTN resolution, and 79.4% T2DM resolution. %EWL was found to decrease slightly with increased age, however no difference in %EWL was found between types of surgery or genders. Conclusion: Bariatric surgery is effective and may be justified in patients with super morbid obesity, including the elderly population. However, there is a great need for larger, longitudinal studies. This would be made possible by hospitals employing more regular and systematic reporting of data, and encouragement of patients to follow up.

Five-year Outcomes of Sleeve Gastrectomy: A Prospective Multicenter study

2021 ◽  
pp. 000313482199198
Author(s):  
Imad El Moussaoui ◽  
Etienne Van Vyve ◽  
Hubert Johanet ◽  
André Dabrowski ◽  
Arnaud Piquard ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Body Mass ◽  
Excess Weight Loss ◽  
Prospective Multicenter Study ◽  
Weight Loss Failure ◽  
Obstructive Sleep ◽  
The Mean ◽  
Predictors Of Weight Loss

Background Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in the world. Our purpose was to evaluate the percentage of excess weight loss (%EWL), resolution of obesity-related comorbidities after SG, and identify predictive factors of weight loss failure. Methods A prospective cohort study of adults who underwent SG during 2014 in 7 Belgian-French centers. Their demographic, preoperative, and postoperative data were prospectively collected and analyzed statistically. Results Overall, 529 patients underwent SG, with a mean preoperative weight and body mass index (BMI) of 118.9 ± 19.9 kg and 42.9 ± 5.5 kg/m2, respectively. Body mass index significantly decreased to 32.2 kg/m2 at 5 years ( P < .001). The mean %EWL was 63.6% at 5 years. A significant reduction in dyslipidemia (28.0%-18.2%), obstructive sleep apnea (OSAS) (34.6%-25.1%), and arterial hypertension (HTN) (30.4%-21.5%) was observed after 5 years, but not for diabetes and gastroesophageal reflux disease (GERD). At multivariate analysis, age >50 years old, BMI >50 kg/m2, and previous laparoscopic adjustable gastric banding (LAGB) remained independent predictors of weight loss failure. Conclusions Five years after SG, weight loss was satisfactory; the reduction of comorbidities was significant for dyslipidemia, OSAS, and HTN, but not diabetes and GERD. Age >50 years old, BMI >50 kg/m2, and previous LAGB were independent predictors of weight loss failure.

scholarly journals Effect of ventilation therapy on mortality rate among obesity hypoventilation syndrome and obstructive sleep apnoea patients

2020 ◽  
Vol 6 (2) ◽  
pp. 00101-2019 ◽  
Author(s):  
Hanna-Riikka Kreivi ◽  
Tuomas Itäluoma ◽  
Adel Bachour
Keyword(s):  
Body Mass Index ◽  
Mortality Rate ◽  
Body Mass ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Control Group ◽  
Obesity Hypoventilation Syndrome ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

IntroductionThe prevalence of obesity is continually increasing worldwide, which increases the incidence of obesity hypoventilation syndrome (OHS) and its consequent mortality.MethodsWe reviewed the therapy mode, comorbidity and mortality of all OHS patients treated at our hospital between 2005 and 2016. The control group consisted of randomly selected patients with obstructive sleep apnoea (OSA) treated during the same period.ResultsWe studied 206 OHS patients and 236 OSA patients. The OHS patients were older (56.3 versus 52.3 years, p<0.001) and heavier (body mass index 46.1 versus 32.2 kg·m−2, p<0.001), and the percentage of women was higher (41.2% versus 24.2%, p<0.001), respectively. The OHS patients had more hypertension (83% versus 61%, p<0.001) and diabetes (62% versus 31%, p<0.001) than the OSA patients, but no higher stroke (4% versus 8%, p=0.058) or ischaemic heart disease (14% versus 15%, p=0.437) incidence. The 5- and 10-year, unadjusted survival rates were lower among the OHS patients than among the OSA patients (83% versus 96% and 74% versus 91%, respectively; p<0.001). Differences in mortality rates were not related to age, sex or body mass index; covariates such as Charlson Comorbidity Index and ventilation therapy predicted survival. The mortality rate decreased significantly (p<0.001) both in OHS and OSA patients even after adjusting for covariates.ConclusionsThe mortality rate in OHS was significantly higher than that in OSA patients even after adjusting for covariates. Ventilation therapy by continuous positive airway pressure or noninvasive ventilation have reduced mortality significantly in all patients.

scholarly journals Correlation of body mass index and pulmonary hypertension in patients with obstructive sleep apnoea

2021 ◽  
Vol 8 (2) ◽  
pp. 79-82
Author(s):  
Saurabh Mishra ◽  
G N Srivastava ◽  
J K Mishra ◽  
Ritamvara Oli
Keyword(s):  
Body Mass Index ◽  
Pulmonary Hypertension ◽  
Body Mass ◽  
Obstructive Sleep Apnoea ◽  
Severe Obesity ◽  
Strong Association ◽  
Sleep Apnoea ◽  
Cardiac Anomaly ◽  
2D Echocardiography ◽  
Obstructive Sleep

Obstructive sleep apnoea has very strong association with both body mass index and pulmonary hypertension. There is a paucity of data to relate BMI and PH in patients with OSA. To see the relation between body mass index and pulmonary hypertension in patients with obstructive sleep apnoea. Patients with symptoms of OSA were screened for polysomnography by using STOP-BANG criteria. 100 patients with AHI ≥5 with symptoms of obstructive sleep apnoea and AHI ≥ 15 without symptoms of obstructive sleep apnoea were selected for other investigations. Neck circumference was measured and BMI was calculated to estimate the severity of obstruction. PFT and chest X-ray were done to rule-out other respiratory illnesses. 2D-echocardiography was done for screening of pre-existing structural cardiac anomaly or any raise in pulmonary artery pressure. MRI neck was done to check neck muscles status. Out of 100 patients in study group 10% (n=10) had mild, 12% (n=12) had moderate and 78% (n=78) had severe OSA. Most of the patients belonged to overweight (52%) and obesity stage 1 (34%) groups. 10% and 2% of the patients belonged to obesity stage 2 and severe obesity groups respectively. Only 2% of the patients were healthy and none of the patients were underweight. PH was present in 24% (n=24) of cases, mild (n=10) and moderate (n=10) PH each were 10% and severe (n=4) PH was present in 4% of the cases. 100% of the patients with severe obesity had pulmonary hypertension. Most of the patients with PH belonged to Obesity grade 1 and overweight groups, whereas none of normal BMI patients had PH. Body mass index has indirect relation with pulmonary hypertension. In our study, we found that pulmonary hypertension was present only in overweight and obese patients. Whereas, none of the patients with normal BMI had pulmonary hypertension.

scholarly journals Obstructive sleep apnoea in women with idiopathic intracranial hypertension: a sub-study of the idiopathic intracranial hypertension weight randomised controlled trial (IIH: WT)

2021 ◽  
Author(s):  
Andreas Yiangou ◽  
James L. Mitchell ◽  
Matthew Nicholls ◽  
Yu Jeat Chong ◽  
Vivek Vijay ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Intracranial Hypertension ◽  
Obstructive Sleep Apnoea ◽  
Idiopathic Intracranial Hypertension ◽  
Epworth Sleepiness Scale ◽  
Sleep Apnoea ◽  
Screening Tools ◽  
Obstructive Sleep ◽  
Randomised Controlled

Abstract Objective Obesity is a risk factor for idiopathic intracranial hypertension (IIH) and obstructive sleep apnoea (OSA). We aimed to determine the prevalence of OSA in IIH and evaluate the diagnostic performance of OSA screening tools in IIH. Additionally, we evaluated the relationship between weight loss, OSA and IIH over 12 months. Methods A sub-study of a multi-centre, randomised controlled parallel group trial comparing the impact of bariatric surgery vs. community weight management intervention (CWI) on IIH-related outcomes over 12 months (IIH:WT). OSA was assessed using home-based polygraphy (ApneaLink Air, ResMed) at baseline and 12 months. OSA was defined as an apnoea–hypopnoea index (AHI) ≥ 15 or ≥ 5 with excessive daytime sleepiness (Epworth Sleepiness Scale ≥11 ). Results Of the 66 women in the IIH: WT trial, 46 were included in the OSA sub-study. OSA prevalence was 47% (n = 19). The STOP-BANG had the highest sensitivity (84%) compared to the Epworth Sleepiness Scale (69%) and Berlin (68%) to detect OSA. Bariatric surgery resulted in greater reductions in AHI vs. CWI (median [95%CI] AHI reduction of  – 2.8 [ – 11.9, 0.7], p = 0.017). Over 12 months there was a positive association between changes in papilloedema and AHI (r = 0.543, p = 0.045), despite adjustment for changes in the body mass index (R2 = 0.522, p = 0.017). Conclusion OSA is common in IIH and the STOP-BANG questionnaire was the most sensitive screening tool. Bariatric surgery improved OSA in patients with IIH. The improvement in AHI was associated with improvement in papilloedema independent of weight loss. Whether OSA treatment has beneficial impact on papilloedema warrants further evaluation. Trial registration number IIH: WT is registered as ISRCTN40152829 and on ClinicalTrials.gov as NCT02124486 (28/04/2014).

Association of epicardial fat thickness with clinical and polysomnographic parameters in non-obese obstructive sleep apnoea patients

2018 ◽  
Vol 132 (5) ◽  
pp. 439-445 ◽  
Author(s):  
S Derin ◽  
I Altun ◽  
S Koseoglu ◽  
C Sahin ◽  
M Yilmaz ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Epicardial Fat ◽  
Epicardial Fat Thickness ◽  
Oxygen Desaturation Index ◽  
Obstructive Sleep ◽  
Fat Thickness

AbstractObjectives:This study aimed to investigate the relationship of epicardial fat thickness with severity of obstructive sleep apnoea, and clinical and polysomnographic parameters, and to determine independent predictors for epicardial fat thickness.Methods:A total of 84 patients with a body mass index of less than 30 kg/m2 and suspected sleep-disordered breathing were included in the study. The correlations of epicardial fat thickness with polysomnographic and clinical data, and severity of obstructive sleep apnoea, were investigated.Results:Mean epicardial fat thickness was 3.75 ± 1.07 mm in the study group (n = 62) and 2.97 ± 0.62 mm in the control group (n = 22) (p < 0.001). There were significant positive correlations between epicardial fat thickness and: apnoea/hypopnoea index, oxygen desaturation index 3 and minimum oxygen saturation, as well as with age, body mass index, and neck and waist circumferences.Conclusion:Non-obese obstructive sleep apnoea patients have thicker epicardial fat compared to controls. Oxygen desaturation index 3 has a strong correlation with epicardial fat thickness and is an independent predictor of it.

scholarly journals Changes in C-reactive protein, neopterin and lactoferrin differ after conservative and surgical weight loss in individuals with morbid obesity

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Martin Aasbrenn ◽  
Per G. Farup ◽  
Vibeke Videm
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Body Mass ◽  
Weight Loss Intervention ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Surgical Weight Loss ◽  
Weight Loss Interventions

AbstractC-reactive protein, neopterin and lactoferrin are biomarkers of atherosclerotic disease. We aimed to assess changes in these biomarkers after conservative and surgical weight loss interventions in individuals with morbid obesity, to evaluate associations between biomarker changes and changes in body mass index and HbA1c, and to study associations between changes in the biomarkers. C-reactive protein, neopterin and lactoferrin were measured before and after conservative weight loss intervention and bariatric surgery. Data were analysed with mixed models. 137 individuals (mean age 43 years) were included. Body mass index decreased from 42.1 kg/m2 to 38.9 kg/m2 after the conservative intervention, and further to 30.5 kg/m2 after bariatric surgery. All biomarkers decreased after the conservative weight loss intervention. C-reactive protein and lactoferrin continued to decrease following bariatric surgery whereas neopterin remained stable. After adjustments for change in body mass index and HbA1c, all biomarkers decreased significantly after the conservative weight loss intervention, whereas none changed after bariatric surgery. There were no consistent correlations between changes in C-reactive protein, neopterin and lactoferrin. In conclusion, biomarkers of atherosclerosis decreased after weight loss interventions but had different trajectories. Neopterin, a marker related to atherosclerotic plaque stability, decreased after conservative weight loss but not following bariatric surgery.

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