Therapeutic effect of laparoscopic sleeve gastrectomy on obstructive sleep apnea and relationship of type 2 diabetes in Japanese patients with severe obesity.

Publisher: Asian Association for the Study of Diabetes and Blackwell Pub. Asia Country of Publication: Japan NLM ID: 101520702 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2040-1124 (Electronic) Linking ISSN: 20401116 NLM ISO Abbreviation: J Diabetes Investig Subsets: MEDLINE

Original Publication: Tokyo : Asian Association for the Study of Diabetes and Blackwell Pub. Asia

Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/surgery ; Laparoscopy* ; Obesity, Morbid*/complications ; Obesity, Morbid*/surgery ; Sleep Apnea, Obstructive*/complications ; Sleep Apnea, Obstructive*/diagnosis ; Sleep Apnea, Obstructive*/surgery; Gastrectomy/methods ; Humans ; Japan ; Obesity/surgery

Aims/introduction: Obstructive 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 Methods: Between 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.
Results: The 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.
Conclusions: Laparoscopic 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.
(© 2022 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

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Keywords: Laparoscopic sleeve gastrectomy; Obstructive sleep apnea; Type 2 diabetes

Date Created: 20220126 Date Completed: 20220602 Latest Revision: 20220716

20250114

PMC9153837

10.1111/jdi.13755

35080135