The Changes Of Sleep-disordered Breathing Parameters And Renal Function Indexes In Obese Patients With OSA After Bariatric Surgery

Objective:To study the relationship between the severity of OSA and renal dysfunction in obese patients with OSA.To study the effect of bariatric surgery on sleep-disordered breathing in obese patients with OSA and its impact on renal function.Methods:62 patients with body mass index（BMI）≥28kg/m² underwent bariatric surgery in the second hospital of Hebei Medical University From January2019 to July 2020.54 patients with OSA were selected by polysomnogram（PSG）and divided into mild,moderate and severe OSA groups according to the apnea hypopnea index（AHI）and the lowest oxygen saturation（LSa O₂）.Collected the general physical condition（BMI,neck circumference,waist circumference）,sleep-disordered breathing parameters（AHI,LSa O₂）and serum biochemical indexes of renal function（creatinine,β₂-microglobulin,Cystatin C）before operation.Objective to investigate the relationship between the severity of OSA and renal dysfunction in obese patients with OSA.Then collected the above indexes after the operation 6 months,and analyzed the changes of the data before and after the operation.Objective to study the effect of bariatric surgery on sleep-disordered breathing in obese patients with OSA and its impact on renal function.Results:1.The analysis of preoperative data showed that the levels ofβ₂-MG and Cys C in severe OSA group were significantly higher than those in mild and moderate OSA group（P<0.05）,and there was no significant difference in Cre level between severe OSA group and mild or moderate OSA group.2.Pearson correlation analysis of preoperative data:Cre,β₂-MG,Cys C were positively correlated with AHI（r=0.304 P=0.025,r=0.649 P=0.000,r=0.708 P=0.000）,and negatively correlated with LSa O₂（r=-0.339 P=0.012,r=-0.589 P=0.000,r=-0.650 P=0.000）.3.After 6 months of bariatric surgery,the BMI,neck circumference and waist circumference of obese patients with severe OSA were significantly decreased（P<0.01）;AHI and LSa O₂ were significantly improved（P<0.01）;Cre had no significant change;β₂-MG and Cys C were significantly decreased（P<0.01）.Conclusions:1.The serum biochemical indexes ofβ₂-MG and Cys C in obese patients with severe OSA exceeded the normal range,but the Cre level was not abnormal,indicating that these patients had early renal function damage.2.Cre,β₂-MG and Cys C were positively correlated with AHI and negatively correlated with LSa O₂ in obese patients with OSA.3.6 months after operation,the levels ofβ₂-MG and Cys C in obese patients with severe OSA were significantly lower than those before operation.The operation has a positive effect on the recovery of renal function in patients with severe OSA.