Are there clinical and demographic differences between morbidly obese patients with and without severe obstructive sleep apnoea?

Laura Hancox, Elizabeth Bonsels, Claire Capper, Maria Palloyova, Dev Banerjee, Shahrad Taheri

Research output: Contribution to journalMeeting abstract

Abstract

Background: Obstructive sleep apnoea (OSA) is highly prevalent in obese adults and independently linked to metabolic disturbances. Our study aimed to determine demographic and clinical differences in morbidly obese patients with severe OSA and those without OSA. Methods: Data was obtained from the Heart of England trust database for 56 morbidly obese (BMI≥40 kg/m 2 ) adults with polysomnographically-established severe OSA (apnoea hypopnea index-AHI≥30 events/hour; n = 30) or no OSA (AHI < 5 events/hour; n = 26). Age, sex, ethnicity, BMI, prevalence of type 2 diabetes (T2DM), HbA1c (DCCT-aligned), and bariatric surgery intervention were compared between the two subgroups at baseline and at 12–18 month follow-up. Results: Compared to non-OSA adults, OSA patients were older (P = 0.005) and more obese (P = 0.025), with trends towards a higher prevalence of T2DM (P = 0.054) and male sex (P = 0.073). The presence of T2DM was associated with older age (P = 0.008), male sex (P = 0.041), and lower minimum oxygen saturation (P = 0.033) in the entire cohort. Follow-up HbA1c values were improved [6.7(6–7.8) vs. 6.6(5.9-7.2)%; P = 0.028] in T2DM patients with treated OSA. There was no significant difference but greater variability in follow-up decrease in HbA1c in OSA T2DM patients on ventilatory treatment who underwent bariatric surgery than in controls without surgical intervention [−0.9 ± 1.15 vs. −1.1 ± 0.27%; P = 0.038]. Conclusion: Obesity, age, and male sex are important risk factors for OSA, even in a morbidly obese population. Complex management of OSA and obesity is associated with improved T2DM control. The greater variability in follow-up HbA1c in T2DM patients undergoing weight-loss surgery highlights the need for improved guidelines for T2DM management after bariatric surgery.
Original languageEnglish
Article numberP08
Pages (from-to)11
Number of pages1
JournalThe British Journal of Surgery
Volume101
Issue numbers3
DOIs
Publication statusPublished - 1 Apr 2014

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Obstructive Sleep Apnea
Demography
Bariatric Surgery
Sleep Apnea Syndromes
Apnea
England
Weight Loss
Obesity
Databases
Guidelines

Bibliographical note

Abstracts of the 5th Annual Scientific Meeting of the British Obesity & Metabolic Surgery Society, (BOMSS) 23-24 January 2014, Leamington Spa, UK

Cite this

Hancox, Laura ; Bonsels, Elizabeth ; Capper, Claire ; Palloyova, Maria ; Banerjee, Dev ; Taheri, Shahrad. / Are there clinical and demographic differences between morbidly obese patients with and without severe obstructive sleep apnoea?. In: The British Journal of Surgery. 2014 ; Vol. 101, No. s3. pp. 11.
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title = "Are there clinical and demographic differences between morbidly obese patients with and without severe obstructive sleep apnoea?",
abstract = "Background: Obstructive sleep apnoea (OSA) is highly prevalent in obese adults and independently linked to metabolic disturbances. Our study aimed to determine demographic and clinical differences in morbidly obese patients with severe OSA and those without OSA. Methods: Data was obtained from the Heart of England trust database for 56 morbidly obese (BMI≥40 kg/m 2 ) adults with polysomnographically-established severe OSA (apnoea hypopnea index-AHI≥30 events/hour; n = 30) or no OSA (AHI < 5 events/hour; n = 26). Age, sex, ethnicity, BMI, prevalence of type 2 diabetes (T2DM), HbA1c (DCCT-aligned), and bariatric surgery intervention were compared between the two subgroups at baseline and at 12–18 month follow-up. Results: Compared to non-OSA adults, OSA patients were older (P = 0.005) and more obese (P = 0.025), with trends towards a higher prevalence of T2DM (P = 0.054) and male sex (P = 0.073). The presence of T2DM was associated with older age (P = 0.008), male sex (P = 0.041), and lower minimum oxygen saturation (P = 0.033) in the entire cohort. Follow-up HbA1c values were improved [6.7(6–7.8) vs. 6.6(5.9-7.2){\%}; P = 0.028] in T2DM patients with treated OSA. There was no significant difference but greater variability in follow-up decrease in HbA1c in OSA T2DM patients on ventilatory treatment who underwent bariatric surgery than in controls without surgical intervention [−0.9 ± 1.15 vs. −1.1 ± 0.27{\%}; P = 0.038]. Conclusion: Obesity, age, and male sex are important risk factors for OSA, even in a morbidly obese population. Complex management of OSA and obesity is associated with improved T2DM control. The greater variability in follow-up HbA1c in T2DM patients undergoing weight-loss surgery highlights the need for improved guidelines for T2DM management after bariatric surgery.",
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Are there clinical and demographic differences between morbidly obese patients with and without severe obstructive sleep apnoea? / Hancox, Laura; Bonsels, Elizabeth; Capper, Claire; Palloyova, Maria; Banerjee, Dev; Taheri, Shahrad.

In: The British Journal of Surgery, Vol. 101, No. s3, P08, 01.04.2014, p. 11.

Research output: Contribution to journalMeeting abstract

TY - JOUR

T1 - Are there clinical and demographic differences between morbidly obese patients with and without severe obstructive sleep apnoea?

AU - Hancox, Laura

AU - Bonsels, Elizabeth

AU - Capper, Claire

AU - Palloyova, Maria

AU - Banerjee, Dev

AU - Taheri, Shahrad

N1 - Abstracts of the 5th Annual Scientific Meeting of the British Obesity & Metabolic Surgery Society, (BOMSS) 23-24 January 2014, Leamington Spa, UK

PY - 2014/4/1

Y1 - 2014/4/1

N2 - Background: Obstructive sleep apnoea (OSA) is highly prevalent in obese adults and independently linked to metabolic disturbances. Our study aimed to determine demographic and clinical differences in morbidly obese patients with severe OSA and those without OSA. Methods: Data was obtained from the Heart of England trust database for 56 morbidly obese (BMI≥40 kg/m 2 ) adults with polysomnographically-established severe OSA (apnoea hypopnea index-AHI≥30 events/hour; n = 30) or no OSA (AHI < 5 events/hour; n = 26). Age, sex, ethnicity, BMI, prevalence of type 2 diabetes (T2DM), HbA1c (DCCT-aligned), and bariatric surgery intervention were compared between the two subgroups at baseline and at 12–18 month follow-up. Results: Compared to non-OSA adults, OSA patients were older (P = 0.005) and more obese (P = 0.025), with trends towards a higher prevalence of T2DM (P = 0.054) and male sex (P = 0.073). The presence of T2DM was associated with older age (P = 0.008), male sex (P = 0.041), and lower minimum oxygen saturation (P = 0.033) in the entire cohort. Follow-up HbA1c values were improved [6.7(6–7.8) vs. 6.6(5.9-7.2)%; P = 0.028] in T2DM patients with treated OSA. There was no significant difference but greater variability in follow-up decrease in HbA1c in OSA T2DM patients on ventilatory treatment who underwent bariatric surgery than in controls without surgical intervention [−0.9 ± 1.15 vs. −1.1 ± 0.27%; P = 0.038]. Conclusion: Obesity, age, and male sex are important risk factors for OSA, even in a morbidly obese population. Complex management of OSA and obesity is associated with improved T2DM control. The greater variability in follow-up HbA1c in T2DM patients undergoing weight-loss surgery highlights the need for improved guidelines for T2DM management after bariatric surgery.

AB - Background: Obstructive sleep apnoea (OSA) is highly prevalent in obese adults and independently linked to metabolic disturbances. Our study aimed to determine demographic and clinical differences in morbidly obese patients with severe OSA and those without OSA. Methods: Data was obtained from the Heart of England trust database for 56 morbidly obese (BMI≥40 kg/m 2 ) adults with polysomnographically-established severe OSA (apnoea hypopnea index-AHI≥30 events/hour; n = 30) or no OSA (AHI < 5 events/hour; n = 26). Age, sex, ethnicity, BMI, prevalence of type 2 diabetes (T2DM), HbA1c (DCCT-aligned), and bariatric surgery intervention were compared between the two subgroups at baseline and at 12–18 month follow-up. Results: Compared to non-OSA adults, OSA patients were older (P = 0.005) and more obese (P = 0.025), with trends towards a higher prevalence of T2DM (P = 0.054) and male sex (P = 0.073). The presence of T2DM was associated with older age (P = 0.008), male sex (P = 0.041), and lower minimum oxygen saturation (P = 0.033) in the entire cohort. Follow-up HbA1c values were improved [6.7(6–7.8) vs. 6.6(5.9-7.2)%; P = 0.028] in T2DM patients with treated OSA. There was no significant difference but greater variability in follow-up decrease in HbA1c in OSA T2DM patients on ventilatory treatment who underwent bariatric surgery than in controls without surgical intervention [−0.9 ± 1.15 vs. −1.1 ± 0.27%; P = 0.038]. Conclusion: Obesity, age, and male sex are important risk factors for OSA, even in a morbidly obese population. Complex management of OSA and obesity is associated with improved T2DM control. The greater variability in follow-up HbA1c in T2DM patients undergoing weight-loss surgery highlights the need for improved guidelines for T2DM management after bariatric surgery.

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U2 - 10.1002/bjs.2014.101.issue-s3

DO - 10.1002/bjs.2014.101.issue-s3

M3 - Meeting abstract

VL - 101

SP - 11

JO - The British Journal of Surgery

JF - The British Journal of Surgery

SN - 0007-1323

IS - s3

M1 - P08

ER -