Predictive factors for insufficient weight loss after bariatric surgery : does obstructive sleep apnea influence weight loss?Predictive factors for insufficient weight loss after bariatric surgery : does obstructive sleep apnea influence weight loss?
Faculty of Medicine and Health Sciences
26(2016):5, p. 1048-1056
University of Antwerp
Important endpoints of bariatric surgery are weight loss and improvement of comorbidities, of which obstructive sleep apnea (OSA) is the highest accompanying comorbidity (70 %). This study aimed to evaluate the influence of OSA on weight loss after bariatric surgery and to provide predictive factors for insufficient weight loss (defined as a parts per thousand currency sign50 % excess weight loss (EWL)) at 1 year follow-up. All consecutive patients, who underwent primary laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy between 2006 and 2014 were retrospectively reviewed. Patients with data on preoperative apnea-hypopnea index (AHI) and pre- and postoperative body mass index (BMI) were included. After surgery, the percentage excess weight loss (%EWL) and BMI changes were compared between preoperatively diagnosed OSA-, subdivided in mild, moderate, and severe OSA, and non-OSA patients. Multivariable logistic regression analysis evaluated predictive factors for a parts per thousand currency sign50 % EWL. A total of 816 patients, 522 (64 %) with and 294 (36 %) without OSA, were included. After 1 year, OSA patients achieved less %EWL than non-OSA patients (65.5 SD 20.7 versus 70.3 SD 21.0; p < 0.01). The lowest %EWL was seen in severe OSA patients (61.7 SD 20.2). However, when adjusted for waist circumference, BMI, and age, no effect of OSA was seen on %EWL or changes in BMI. Although AHI, gender, age, BMI, type of surgery, and type II diabetes were predictive factors for a parts per thousand currency sign50 % EWL (area under the curve 0.778), the AHI as variable was of little importance. The presence of OSA does not individually impair weight loss after bariatric surgery.