Effect of sleep surgery on lipid profiles in adults with obstructive sleep apnea: a meta-analysis.

Chia-Hsuan Lee, Wei-Chung Hsu, Te-Huei Yeh, Jenq-Yuh Ko, Ming-Tzer Lin, Kun-Tai Kang

Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2022;279(8):3811-3820

PMID: 35570203

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Abstract

PURPOSE

The effects of sleep surgery on the lipid profile of adults diagnosed as having obstructive sleep apnea (OSA) remain unclear. This meta-analysis aimed to clarify whether sleep surgeries improve patients' lipid profile.

METHODS

The study protocol was registered on PROSPERO (CRD42020154425). Two authors independently searched the PubMed, MEDLINE, EMBASE, and Cochrane review databases up to September 2020 using keywords such as sleep apnea, OSA, sleep apnea syndromes, lipids, and surgery. The effects of sleep surgery on the apnea-hypopnea index (AHI) and lipid profile parameters were evaluated using a random-effects model.

RESULTS

Thirteen studies were included, with a total of 710 patients (mean age: 42.0 years; 85% men; mean sample size: 54.6 patients). The summary estimate of AHI change was - 20.6 events/h (95% CI - 25.9 to - 15.3) and the Epworth Sleepiness Scale score was - 4.2 (95% CI - 5.9 to - 2.5). Sleep surgery lowered total cholesterol (mean - 7.7 mg/dL; 95% CI - 12.2 to - 3.2), low-density lipoprotein (mean - 7.2 mg/dL; 95% CI - 11.0 to - 3.3), and triglyceride (mean - 14.0 mg/dL; 95% CI - 22.2 to - 5.8) levels but did not affect high-density lipoprotein (mean 1.5 mg/dL; 95% CI - 0.6 to 3.7) levels. Subgroup analysis revealed that the lipid profile changes were not associated with the surgical procedure but with the degree of OSA improvement. Meta-regression analyses demonstrated that the improvement in the lipid profile was positively correlated with AHI reduction.

CONCLUSION

Surgeries for OSA may improve the lipid profile, which is positively correlated with the degree of OSA improvement.

Address: Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, No. 127, Siyuan Rd., Xinzhuang Dist., New Taipei City, Taiwan.; Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan.; Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.; Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan.; Sleep Center, National Taiwan University Hospital, Taipei, Taiwan.; Sleep Center, National Taiwan University Hospital, Taipei, Taiwan. [email protected].; Department of Internal Medicine, Hsiao Chung-Cheng Hospital, New Taipei City, Taiwan. [email protected].; Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, No. 127, Siyuan Rd., Xinzhuang Dist., New Taipei City, Taiwan. [email protected].; Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan. [email protected].; Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan. [email protected].

DOI: 10.1007/s00405-022-07382-y

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https://dx.doi.org/10.1007/s00405-022-07382-y

MeSH Terms: Adult, Female, Humans, Lipoproteins, HDL, Male, Sleep, Sleep Apnea Syndromes, Sleep Apnea, Obstructive, Triglycerides