Therapeutic effect of laparoscopic sleeve gastrectomy on obstructive sleep apnea and relationship of type 2 diabetes in Japanese patients with severe obesity |
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Authors: | Shingo Yanari Akira Sasaki Akira Umemura Yasushi Ishigaki Haruka Nikai Tsuguo Nishijima Shigeru Sakurai |
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Affiliation: | 1. Department of Surgery, Iwate Medical University, Iwate Japan ; 2. Division of Diabetes and Metabolism and Endocrine Medicine Field, Department of Internal Medicine, Iwate Medical University, Iwate Japan ; 3. Division of Behavioral Sleep Medicine, Iwate Medical University, Iwate Japan ; 4. Seimindo Sleep Labo Systems, Iwate Japan |
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Abstract: | Aims/IntroductionObstructive sleep apnea (OSA) is among the most important obesity‐related diseases, and offers the potential for accelerated the early onset and progression of type 2 diabetes. The aim of the present study was to clarify the therapeutic effect of laparoscopic sleeve gastrectomy on OSA in severely obese Japanese patients, and to find correlations between OSA improvements and β‐cell function (BCF).Materials and MethodsBetween September 2013 and December 2019, 61 patients who underwent laparoscopic sleeve gastrectomy were enrolled. The apnea–hypopnea index (AHI) was used to diagnose OSA. The tongue area, uvula area and other parameters were measured using cone‐beam computed tomography. Regarding BCF parameters, the homeostasis model assessment of β‐cell function, insulinogenic, Matsuda and disposition indexes were used to evaluate the improvement in BCF. Improvement of OSA was defined as AHI <15.ResultsThe improvement rate of OSA was 51.8% (29/56). The change in AHI was significantly correlated with the excess weight loss percentage (ρ = 0.501), changes in tongue area (ρ = 0.350) and uvula area (ρ = 0.341). Multivariate analysis showed that preoperative AHI and postoperative hemoglobin A1c were independent prognostic factors of OSA non‐improvement. The homeostasis model assessment of β‐cell function (P < 0.001), the insulinogenic index (P < 0.001) and the disposition index (P = 0.019) of patients with AHI of <15 were significantly higher than those in patients with AHI of ≥15.ConclusionsLaparoscopic sleeve gastrectomy is a promising procedure for severely obese patients with OSA. BCF recovery was found to be significantly higher in patients with OSA improvement. |
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Keywords: | Laparoscopic sleeve gastrectomy, Obstructive sleep apnea, Type 2 diabetes |
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