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Predictive Factors for Insufficient Weight Loss After Bariatric Surgery: Does Obstructive Sleep Apnea Influence Weight Loss?

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Abstract

Background

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 ≤50 % excess weight loss (EWL)) at 1 year follow-up.

Methods

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 ≤50 % EWL.

Results

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 ≤50 % EWL (area under the curve 0.778), the AHI as variable was of little importance.

Conclusions

The presence of OSA does not individually impair weight loss after bariatric surgery.

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Abbreviations

AHI:

Apnea-hypopnea index

BMI:

Body mass index

CPAP:

Continuous positive airway pressure

(%) EWL:

Percentage excess weight loss

LRYGB:

Laparoscopic roux-en-Y gastric bypass

LSG:

Laparoscopic sleeve gastrectomy

OSA:

Obstructive sleep apnea

PG:

Polygraphy

PSG:

Polysomnography

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Conflicts of Interest

The authors declare that they have no competing interests.

Compliance with Ethical Standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As this was a retrospective study, formal national consent is not required.

Informed Consent

Does not apply.

Funding

There was no funding source for this study.

Author information

Authors and Affiliations

  1. Department of Surgery, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands

    Christel A. L. de Raaff, Usha K. Coblijn, Willem F. van Tets & Bart A. van Wagensveld

  2. Department of Otolaryngology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands

    Nico de Vries

  3. Department of Otolaryngology, University of Antwerp, Antwerp, Belgium

    Nico de Vries

  4. Department of Epidemiology and Biostatistics, VU Medical Center, Amsterdam, The Netherlands

    Martijn W. Heymans

  5. Department of Methodology and Applied Biostatistics, Faculty of Health and Life Sciences, VU Amsterdam, Amsterdam, The Netherlands

    Martijn W. Heymans

  6. Department of Pulmonology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands

    Bob T. J. van den Berg

Authors
  1. Christel A. L. de Raaff
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  2. Usha K. Coblijn
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  3. Nico de Vries
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  4. Martijn W. Heymans
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  5. Bob T. J. van den Berg
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  6. Willem F. van Tets
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  7. Bart A. van Wagensveld
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Corresponding author

Correspondence to Christel A. L. de Raaff.

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de Raaff, C.A.L., Coblijn, U.K., de Vries, N. et al. Predictive Factors for Insufficient Weight Loss After Bariatric Surgery: Does Obstructive Sleep Apnea Influence Weight Loss?. OBES SURG 26, 1048–1056 (2016). https://doi.org/10.1007/s11695-015-1830-4

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  • DOI: https://doi.org/10.1007/s11695-015-1830-4

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