Objectives/Hypothesis
To evaluate associations between sleep surgery and CRP (C‐reactive protein) levels in adults with obstructive sleep apnea (OSA).
Study Design
Meta‐analysis.
Methods
Two authors independently searched PubMed, Medline, EMBASE, and Cochrane review databases until July 2019. The keywords used were sleep apnea, OSA, sleep apnea syndromes, surgery, C‐reactive protein (CRP), and inflammatory markers. The effects of sleep surgery on CRP levels were examined using a random‐effects model.
Results
Nine studies with 277 patients were analyzed (mean age: 46.5 years; 92% men; mean sample size: 30.8 patients). The mean change in the apnea–hypopnea index (AHI) after surgery was significantly reduced by −21.1 (95% confidence interval [CI], −28.4 to −13.7) events/hr. Overall, sleep surgery resulted in a significant reduction of CRP levels in patients with OSA (standardized mean difference [SMD] = −0.39, 95% CI, −0.67 to −0.11). Patients with postoperative AHI reduction >20 events/hr achieved a greater reduction in CRP than those with AHI reduction <20 events/hr (SMD: −0.72 vs. −0.14, P for heterogeneity = .007). According to subgroup analysis, differences in the CRP levels after surgery were nonsignificant in the different countries (i.e., United States vs. other countries), CRP types (i.e., CRP vs. high‐sensitivity CRP), surgical procedures (i.e., pharyngeal surgery vs. other surgical procedures), and follow‐up period (i.e., <6 vs. >6 months).
Conclusions
Sleep surgery for OSA resulted in a significant reduction of CRP levels in adults. The beneficial effect of surgery on CRP levels is greater in patients with large improvement in OSA (i.e., AHI reduction >20 events/hr) after sleep surgery. Laryngoscope, 2020
No comments:
Post a Comment