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

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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.

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Funding

This study was supported by grant from Taipei Hospital, Ministry of Health and Welfare (202010 and 202011).

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, No. 127, Siyuan Rd., Xinzhuang Dist., New Taipei City, Taiwan

    Chia-Hsuan Lee & Kun-Tai Kang

  2. Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan

    Chia-Hsuan Lee

  3. Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan

    Wei-Chung Hsu, Te-Huei Yeh, Jenq-Yuh Ko & Kun-Tai Kang

  4. Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan

    Wei-Chung Hsu, Te-Huei Yeh & Jenq-Yuh Ko

  5. Sleep Center, National Taiwan University Hospital, Taipei, Taiwan

    Wei-Chung Hsu, Te-Huei Yeh & Ming-Tzer Lin

  6. Department of Internal Medicine, Hsiao Chung-Cheng Hospital, New Taipei City, Taiwan

    Ming-Tzer Lin

  7. Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan

    Kun-Tai Kang

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  1. Chia-Hsuan Lee
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Contributions

Kang KT and Lin MT both equally participated in this study’s design and coordination and are acknowledged as co-corresponding authors. All authors read and approved the final manuscript. The authors would like to thank the editor and the anonymous reviewers for their comments.

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Correspondence to Ming-Tzer Lin or Kun-Tai Kang.

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Supplementary Information

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Supplementary file1 (DOC 99 kb)

405_2022_7382_MOESM2_ESM.tif

Supplement figure 1 Meta-regression analyses of correlations between change in AHI and change in total cholesterol (TIF 1439 kb)

405_2022_7382_MOESM3_ESM.tif

Supplement figure 2 Meta-regression analyses of associations between change in AHI and change in low-density lipoprotein (TIF 2029 kb)

405_2022_7382_MOESM4_ESM.tif

Supplement figure 3 Meta-regression analyses of associations between change in AHI and change in high-density lipoprotein (TIF 2196 kb)

405_2022_7382_MOESM5_ESM.tif

Supplement figure 4 Meta-regression analyses of associations between change in AHI and change in triglyceride (TIF 2097 kb)

Supplement figure 5 Funnel plot for publication bias in total cholesterol (TIF 1634 kb)

Supplement figure 6 Funnel plot for publication bias in low-density lipoprotein (TIF 1593 kb)

Supplement figure 7 Funnel plot for publication bias in high-density lipoprotein (TIF 1590 kb)

Supplement figure 8 Funnel plot for publication bias in triglyceride (TIF 1666 kb)

405_2022_7382_MOESM10_ESM.tif

Supplement figure 9 Forest plot showing the mean AHI change after sleep surgery (exclude isolated nasal surgery) (TIF 1226 kb)

405_2022_7382_MOESM11_ESM.tif

Supplement figure 10 Forest plot showing changes in (A) total cholesterol and (B) low-density lipoprotein (C) high-density lipoprotein (D) triglyceride after sleep surgery (exclude isolated nasal surgery) (TIF 2559 kb)

405_2022_7382_MOESM12_ESM.tif

Supplement figure 11 Forest plot comparing changes in lipid profiles in patients with mean AHI reduction < 20 vs. > 20 events/hour after surgery (exclude isolated nasal surgery) (TIF 1209 kb)

405_2022_7382_MOESM13_ESM.tif

Supplement figure 12 Meta-regression analyses of correlations between change in AHI and change in total cholesterol (exclude isolated nasal surgery) (TIF 978 kb)

405_2022_7382_MOESM14_ESM.tif

Supplement figure 13 Meta-regression analyses of associations between change in AHI and change in low-density lipoprotein (exclude isolated nasal surgery) (TIF 977 kb)

405_2022_7382_MOESM15_ESM.tif

Supplement figure 14 Meta-regression analyses of associations between change in AHI and change in high-density lipoprotein (exclude isolated nasal surgery) (TIF 1006 kb)

405_2022_7382_MOESM16_ESM.tif

Supplement figure 15 Meta-regression analyses of associations between change in AHI and change in triglyceride (exclude isolated nasal surgery) (TIF 920 kb)

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Lee, CH., Hsu, WC., Yeh, TH. et al. Effect of sleep surgery on lipid profiles in adults with obstructive sleep apnea: a meta-analysis. Eur Arch Otorhinolaryngol 279, 3811–3820 (2022). https://doi.org/10.1007/s00405-022-07382-y

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