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Study Objectives: <p>This study aimed to assess the effectiveness of metabolic and bariatric surgery in patients with obesity comorbid with obesity hypoventilation syndrome (OHS) at 1-year follow-up.</p> Methods: <p>This retrospective study was conducted between January 2020 and June 2023 at a metabolic and bariatric surgery center in a university-affiliated tertiary hospital in China. Clinical data, including body mass index, arterial blood gas values, portable sleep study results, and anthropometric parameters, were recorded pre- and postoperatively. Correlations between variables and risk factors for OHS resolution were analyzed.</p> Results: <p>Among 1,134 candidates for metabolic and bariatric surgery, 187 (16.5%) had comorbid OHS; 151 patients with OHS met inclusion criteria and completed the 1-year follow-up visit (body mass index 39.1 ± 6.8 kg/m<sup>2</sup> with partial pressure of carbon dioxide in arterial blood [PaCO<sub>2</sub>] 48.6 ± 3.0 mmHg). At 1-year follow-up, body mass index decreased to 29.0 ± 6.0 kg/m<sup>2</sup> (<i>P</i> &lt; .001) and PaCO<sub>2</sub> dropped to 43.8 ± 5.5 mmHg (<i>P</i> &lt; .001). Resolution of OHS, defined as awake PaCO<sub>2</sub> &lt; 45 mmHg with discontinuation of positive airway pressure therapy for a minimum of 6 months before obtaining the arterial blood gas at the 12-month visit, was achieved in 105 (69.5%) of the patients. Nonlinear analysis indicated that PaCO<sub>2</sub> did not significantly decrease until the percentage of total weight loss exceeded approximately 20%. A larger reduction in waist circumference was associated with a greater reduction in PaCO<sub>2</sub>, particularly when waist circumference reached less than 25 cm. Beyond this point, ΔPaCO<sub>2</sub> reached a plateau. In multivariate analysis, a larger preoperative waist circumference (odds ratio: 1.046, 95% confidence interval: 1.031–1.118, <i>P =</i> .025) and arterial blood gas pH &lt; 7.35 (odds ratio: 3.921, 95% confidence interval: 2.305–9.140, <i>P</i> &lt; .001) were associated with lack of resolution of OHS, and a larger percentage of total weight loss after bariatric surgery (odds ratio: 0.917, 95% confidence interval: 0.846–0.965, <i>P =</i> .001) was independently associated with OHS resolution.</p> Conclusions: <p>Metabolic and bariatric surgery is an effective treatment for OHS. Achieving a sufficient percentage of total weight loss is critical for the resolution of OHS.</p> Citation: <p>Ma S, Yu W, Yang C, et&#xa0;al. Impact of bariatric surgery on the resolution of obesity hypoventilation syndrome at 1-year follow-up: a retrospective study. <i>J Clin Sleep Med.</i> 2025;21(10):1665–1678.</p>

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Impact of bariatric surgery on the resolution of obesity hypoventilation syndrome at 1-year follow-up: a retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月1日

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  • Shuai Ma,
  • Wenwen Yu,
  • Chengcan Yang,
  • Yining He,
  • Dongzi Zhu,
  • Fen Gu,
  • Bei Xu,
  • Xiaozhen Xu,
  • Kan Yao,
  • Xiurong Tao,
  • Min Zhu,
  • Bing Wang

摘要

Study Objectives:

This study aimed to assess the effectiveness of metabolic and bariatric surgery in patients with obesity comorbid with obesity hypoventilation syndrome (OHS) at 1-year follow-up.

Methods:

This retrospective study was conducted between January 2020 and June 2023 at a metabolic and bariatric surgery center in a university-affiliated tertiary hospital in China. Clinical data, including body mass index, arterial blood gas values, portable sleep study results, and anthropometric parameters, were recorded pre- and postoperatively. Correlations between variables and risk factors for OHS resolution were analyzed.

Results:

Among 1,134 candidates for metabolic and bariatric surgery, 187 (16.5%) had comorbid OHS; 151 patients with OHS met inclusion criteria and completed the 1-year follow-up visit (body mass index 39.1 ± 6.8 kg/m2 with partial pressure of carbon dioxide in arterial blood [PaCO2] 48.6 ± 3.0 mmHg). At 1-year follow-up, body mass index decreased to 29.0 ± 6.0 kg/m2 (P < .001) and PaCO2 dropped to 43.8 ± 5.5 mmHg (P < .001). Resolution of OHS, defined as awake PaCO2 < 45 mmHg with discontinuation of positive airway pressure therapy for a minimum of 6 months before obtaining the arterial blood gas at the 12-month visit, was achieved in 105 (69.5%) of the patients. Nonlinear analysis indicated that PaCO2 did not significantly decrease until the percentage of total weight loss exceeded approximately 20%. A larger reduction in waist circumference was associated with a greater reduction in PaCO2, particularly when waist circumference reached less than 25 cm. Beyond this point, ΔPaCO2 reached a plateau. In multivariate analysis, a larger preoperative waist circumference (odds ratio: 1.046, 95% confidence interval: 1.031–1.118, P = .025) and arterial blood gas pH < 7.35 (odds ratio: 3.921, 95% confidence interval: 2.305–9.140, P < .001) were associated with lack of resolution of OHS, and a larger percentage of total weight loss after bariatric surgery (odds ratio: 0.917, 95% confidence interval: 0.846–0.965, P = .001) was independently associated with OHS resolution.

Conclusions:

Metabolic and bariatric surgery is an effective treatment for OHS. Achieving a sufficient percentage of total weight loss is critical for the resolution of OHS.

Citation:

Ma S, Yu W, Yang C, et al. Impact of bariatric surgery on the resolution of obesity hypoventilation syndrome at 1-year follow-up: a retrospective study. J Clin Sleep Med. 2025;21(10):1665–1678.