Obesity hypoventilation syndrome in bariatric surgery patients: an underestimated disease |
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| Institution: | 1. Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China;2. Respiratory and Sleep Department, the First Affiliated Hospital of Jinan University, Guangzhou, China;1. Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy;2. Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy;3. Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy;4. Bariatric Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy;5. Department of Medical Physics, Policlinico S. Orsola-Malpighi, Bologna, Italy;1. Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;2. Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;3. Department of Exercise Physiology, University of Isfahan, Isfahan, Iran;4. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;5. Department of Health and Human Performance, Marymount University, Arlington, Virginia;6. Sepidan Bagherololoom Higher Education College, Shiraz University of Medical Sciences, Shiraz, Iran;7. Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;1. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania;2. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;3. Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania |
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| Abstract: | BackgroundObesity is a known risk factor for obesity hypoventilation syndrome (OHS). However, study on the prevalence and clinical characteristics of OHS among bariatric surgery patients is scarce.ObjectivesTo investigate the prevalence of OHS in bariatric surgery patients and to identify its related predictors.SettingThe study was conducted at a bariatric surgery center in a tertiary university hospital.MethodsA cross sectional analysis was performed in the patients undergoing bariatric surgery between March 2017 and January 2020. Anthropometric, laboratory, pulmonary function, blood gas analysis, and polysomnographic data was collected and analyzed.ResultsOf 522 patients, the overall prevalence of OHS was 15.1%, with men (22.8 %) having a greater frequency than women (9.4%) (P < .001). The prevalence increases with obesity severity, from 4.1% in those with body mass index (BMI) <35 kg/m2 to 39.1% in those with BMI ≥50 kg/m2. Of 404 patients with obstructive sleep apnea (OSA), OHS was present in 17.3%, with 9.8% in mild OSA, 10.0% in moderate OSA, and 27.3%in severe OSA. Only 11.4% of patients diagnosed with OHS had no OSA. On logistic regression, BMI (odds ratio OR]: 1.10; 95% confidence interval CI], 1.01–1.21; P = .033), neck circumference (OR: 1.15; 95% CI, 1.03–1.28; P = .014), serum bicarbonate (OR: 1.39; 95% CI, 1.20–1.61; P = .000), C-reactive protein (CRP) (OR: 1.04; 95% CI, 1.00–1.07; P = .034) were independently associated with OHS.ConclusionIn bariatric surgery patients, OHS presented a high prevalence, especially in men. Higher levels of BMI, neck circumference, serum bicarbonate, and CRP indicated higher risk of OHS. |
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| Keywords: | Obesity hypoventilation syndrome Obstructive sleep apnea Bariatric surgery Obesity |
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