Effect of Sleep Surgery on C-Reactive Protein Levels in Adults With Obstructive Sleep Apnea: A Meta-Analysis
Kun-Tai Kang MD, MPH
Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorTe-Huei Yeh MD, PhD
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan
Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorYing-Shuo Hsu MD
Department of Otolaryngology, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
Search for more papers by this authorJenq-Yuh Ko MD, PhD
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorChia-Hsuan Lee MD, MPH
Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
Search for more papers by this authorCorresponding Author
Ming-Tzer Lin MD
Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, Hsiao Chung-Cheng Hospital, New Taipei City, Taiwan
Send correspondence to Wei-Chung Hsu, Department of Otolaryngology, National Taiwan University Hospital, #7, Chung-Shan South Road, Taipei, Taiwan. E-mail: [email protected]; Ming-Tzer Lin, Department of Internal Medicine, Hsiao Chung-Cheng Hospital, New Taipei, Taiwan. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Wei-Chung Hsu MD, PhD
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan
Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
Send correspondence to Wei-Chung Hsu, Department of Otolaryngology, National Taiwan University Hospital, #7, Chung-Shan South Road, Taipei, Taiwan. E-mail: [email protected]; Ming-Tzer Lin, Department of Internal Medicine, Hsiao Chung-Cheng Hospital, New Taipei, Taiwan. E-mail: [email protected]
Search for more papers by this authorKun-Tai Kang MD, MPH
Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorTe-Huei Yeh MD, PhD
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan
Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorYing-Shuo Hsu MD
Department of Otolaryngology, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
Search for more papers by this authorJenq-Yuh Ko MD, PhD
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorChia-Hsuan Lee MD, MPH
Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan
Search for more papers by this authorCorresponding Author
Ming-Tzer Lin MD
Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
Department of Internal Medicine, Hsiao Chung-Cheng Hospital, New Taipei City, Taiwan
Send correspondence to Wei-Chung Hsu, Department of Otolaryngology, National Taiwan University Hospital, #7, Chung-Shan South Road, Taipei, Taiwan. E-mail: [email protected]; Ming-Tzer Lin, Department of Internal Medicine, Hsiao Chung-Cheng Hospital, New Taipei, Taiwan. E-mail: [email protected]
Search for more papers by this authorCorresponding Author
Wei-Chung Hsu MD, PhD
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
Department of Otolaryngology, College of Medicine, National Taiwan University, Taipei, Taiwan
Sleep Center, National Taiwan University Hospital, Taipei, Taiwan
Send correspondence to Wei-Chung Hsu, Department of Otolaryngology, National Taiwan University Hospital, #7, Chung-Shan South Road, Taipei, Taiwan. E-mail: [email protected]; Ming-Tzer Lin, Department of Internal Medicine, Hsiao Chung-Cheng Hospital, New Taipei, Taiwan. E-mail: [email protected]
Search for more papers by this authorAbstract
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, 131:1180–1187, 2021
Supporting Information
| Filename | Description |
|---|---|
| lary29212-sup-0001-Table.docWord document, 85 KB | Supporting Table 1. MeSH terms and keywords used in searching process Supporting Table 2. Searching process in database Supporting Table 3. Newcastle-Ottawa Scale Quality Assessment of included studies |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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