title: Does airway surgery lower serum lipid levels in obstructive sleep apnea patients? A retrospective case review.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is tightly linked to increased cardiovascular disease. Surgery is an important method to treat OSA, but its effect on serum lipid levels in OSA patients is unknown. We aimed to evaluate the effect of upper airway surgery on lipid profiles.
  
  
  METHODS
  We performed a retrospective review of 113 adult patients with OSA who underwent surgery (nasal or uvulopalatopharyngoplasty [UPPP]) at a major, urban, academic hospital in Beijing from 2012 to 2013 who had preoperative and postoperative serum lipid profiles.
  
  
  RESULTS
  Serum TC (4.86±0.74 to 4.69±0.71) and LP(a) (median 18.50 to 10.90) all decreased significantly post-operatively (P<0.01, 0.01, respectively), with no changes in serum HDL, LDL, or TG (P>0.05, all). For UPPP patients (n=51), serum TC, HDL and LP(a) improved (P=0.01, 0.01,<0.01, respectively). For nasal patients (n=62), only the serum LP(a) decreased (P<0.01). In patients with normal serum lipids at baseline, only serum LP(a) decreased (P<0.01). In contrast, in patients with isolated hypertriglyceridemia, the serum HDL, TG and LP(a) showed significant improvements (P=0.02, 0.03, <0.01, respectively). In patients with isolated hypercholesterolemia, the serum LP(a) decreased significantly (P=0.01), with a similar trend for serum TC (P=0.06). In patients with mixed hyperlipidemia, the serum TC and LDL also decreased (P=0.02, 0.03, respectively).
  
  
  CONCLUSIONS
  Surgery may improve blood lipid levels in patients with OSA, especially in patients with preoperative dyslipidemia, potentially yielding a major benefit in metabolism and cardiovascular sequelae. Prospective studies should examine this potential metabolic effect of airway surgery for OSA.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (mainland).
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland).
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Zhan
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (mainland).
authors.forename: Ningyu
authors.initials: N
authors.lastname: Wang
authors.affiliation: Section of Otolaryngology Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, IL, USA.
authors.forename: Jayant Marian
authors.initials: JM
authors.lastname: Pinto
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland).
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Ge
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (mainland).
authors.forename: Chunyan
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland).
authors.forename: Jun
authors.initials: J
authors.lastname: Tian
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (mainland).
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Wei
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D017286:Polysomnography; D012137:Respiratory System / Q000601:surgery*; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000097:blood*
chemical_list: D008055:Lipids