The Impact of Weight Loss on the Physiological Endotypes Associated With OSA
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Le résumé fourni par la source
Background Weight loss improves upper airway collapsibility in people with OSA. However, it is unclear how weight loss affects the other physiological traits (ie, endotypes) associated with OSA (loop gain, arousal threshold, and muscle compensation). Research Questions What is the effect of metabolic bariatric surgery on the OSA endotypes, and are the baseline endotypes associated with improvements in OSA severity? Study Design and Methods Using noninvasive methods, the OSA endotypes were measured during overnight clinical polysomnography in 43 patients before and after (approximately 6-18 months) metabolic bariatric surgery. OSA endotypes were also measured, using reference standard physiological techniques (ie, CPAP dial-down method) in a subset of patients (n = 10). Generalized linear mixed-effects models were used to evaluate the effect on outcome variables. Results Metabolic bariatric surgery was associated with improvements in apnea-hypopnea index (AHI; 50.7 ± 26.8 vs 24.6 ± 19.2 events/h; P < .001), BMI (42.1 ± 5.5 vs 32.8 ± 4.5 kg/m 2 ; P < .001), upper airway collapsibility (67.0% ± 21.4% vs 72.8% ± 16.2% V eupnea ; P = .011) and loop gain (0.65 ± 0.19 vs 0.58 ± 0.19; P = .011). Weight loss also reduced arousal threshold (149.7% ± 28.6% vs 142.6% ± 30.1% V eupnea ; P = .011). Reference standard measures showed changes consistent with noninvasively derived endotypes. A greater improvement in airway collapsibility was associated with a greater reduction in AHI ( B = –0.62; 95% CI, –0.97 to –0.27; P = .002; R 2 = 0.23), and greater decreases in arousal threshold were associated with greater improvements in AHI ( B = 0.63; 95% CI, 0.33–0.92; P < .001; R 2 = 0.29). Multivariable models controlling for baseline AHI found that those with less-collapsible upper airways and low loop gain at baseline may be more likely to see improvements in their OSA severity after surgery. Interpretation Our results show that metabolic bariatric surgery is associated with improvements in weight, AHI, upper airway collapsibility, and loop gain and may be particularly effective for those with mild upper airway collapsibility and low loop gain.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- The Impact of Weight Loss on the Physiological Endotypes Associated With OSA
- Date Crossref
- 01/07/2026
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Australian Regenerative Medicine Institute pays non établi dans la noticeStructure de recherche
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Monash University Department of Physiology pays non établi dans la noticeUniversité ou école supérieure
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Monash Health pays non établi dans la noticeÉtablissement de santé
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Alfred Health pays non établi dans la noticeÉtablissement de santé
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University of California System Critical Care and Sleep Medicine pays non établi dans la noticeUniversité ou école supérieure
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University of California San Diego pays non établi dans la noticeUniversité ou école supérieure
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The Royal Melbourne Hospital pays non établi dans la noticeOrganisme public
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The Alfred Hospital pays non établi dans la noticeÉtablissement de santé
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Monash Alfred Psychiatry Research centre pays non établi dans la noticeStructure de recherche
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Royal North Shore Hospital pays non établi dans la noticeÉtablissement de santé
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University of Pittsburgh Critical Care and Sleep Medicine pays non établi dans la noticeUniversité ou école supérieure
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Discovery Institute pays non établi dans la noticeOrganisation à but non lucratif
Australian Regenerative Medicine Institute, Department of Physiology — Monash University et Monash Health, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.