Obesity Surgery

, Volume 26, Issue 11, pp 2629–2639 | Cite as

Sex Effect on Obesity Indices and Metabolic Outcomes in Patients with Obese Obstructive Sleep Apnea and Type 2 Diabetes After Laparoscopic Roux-en-Y Gastric Bypass Surgery: a Preliminary Study

  • Huajun Xu
  • Pin Zhang
  • Xiaodong Han
  • Haoyong Yu
  • Jianzhong Di
  • Jianyin Zou
  • Yuyu Wang
  • Yingjun Qian
  • Yinfang Tu
  • Yuqian Bao
  • Hongliang YiEmail author
  • Jian GuanEmail author
  • Shankai Yin
  • Weiping Jia
Original Contributions



Roux-en-Y gastric bypass (RYGB) surgery is an effective therapy for obstructive sleep apnea (OSA). However, little attention has been paid to the treatment goals systematically stratified by sex. The objective of this study was to assess how sex differences affect obesity indices and metabolic outcomes after RYGB surgery.


A sleep questionnaire was conducted and medical histories were taken. Full-night polysomnography (PSG), anthropometric variables, and blood samples were collected.


Thirty-five consecutive patients with OSA who underwent laparoscopic RYGB surgery were prospectively examined for at least 6 months were included in the study. Significant improvements (p < 0.01) in sleep parameters (except for micro-arousal), obesity indices, and metabolic outcomes [except low-density lipoprotein in men and high-density lipoprotein (HDL) in women] were obtained in men and women with OSA. Men had higher baseline triglyceride (TG) (p < 0.01) and lower HDL levels (p < 0.01) but a larger neck circumference (NC) (p = 0.03) at follow-up than did women. However, only TG in men improved more than in women (p = 0.02).


Sleep parameters, obesity indices, and metabolic outcomes after RYGB surgery were of similar magnitude in women and men with OSA. Alleviating sleep and obesity problems was correlated with metabolic outcomes in men and women.


Obstructive sleep apnea Bariatric surgery Obesity Type 2 diabetes Women 



We thank all of the staff and participants of this study for their contributions.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all participants included in the study.

Supplementary material

11695_2016_2140_Fig5_ESM.gif (43 kb)
Supplementary Fig. 1

Simulation procedure for the bootstrap analysis. (GIF 42 kb)

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High resolution image (TIF 20 kb)
11695_2016_2140_Fig6_ESM.gif (41 kb)
Supplementary Fig. 2

Polysomnographic variables measured following bariatric surgery. ESS, Epworth Sleepiness Scale; AHI, apnea–hypopnea index; Mean O2, mean oxygen saturation; LSpO2, lowest pulse oxygen saturation; ODI, oxygen desaturation index; MAI, micro-arousal index. (GIF 41 kb)

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High resolution image (TIF 927 kb)
11695_2016_2140_Fig7_ESM.gif (26 kb)
Supplementary Fig. 3

Obesity indices measured following bariatric surgery. BMI, body mass index; NC, neck circumference; WC, waist circumference; HC, hip circumference. (GIF 26 kb)

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High resolution image (TIF 591 kb)
11695_2016_2140_Fig8_ESM.gif (36 kb)
Supplementary Fig. 4

Metabolic outcomes measured following bariatric surgery. SBP, systolic blood pressure; DBP, diastolic blood pressure; TC, total cholesterol; TG, triglycerides; HDL, high-density lipoprotein cholesterol; LDL, low-density lipoprotein cholesterol; HOMA-IR, homeostasis model assessment–insulin resistance. (GIF 36 kb)

11695_2016_2140_MOESM4_ESM.tif (571 kb)
High resolution image (TIF 570 kb)
11695_2016_2140_MOESM5_ESM.docx (34 kb)
ESM 1 (DOCX 33 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Huajun Xu
    • 1
  • Pin Zhang
    • 2
  • Xiaodong Han
    • 2
  • Haoyong Yu
    • 3
    • 4
  • Jianzhong Di
    • 2
  • Jianyin Zou
    • 1
  • Yuyu Wang
    • 1
  • Yingjun Qian
    • 1
  • Yinfang Tu
    • 3
    • 4
  • Yuqian Bao
    • 3
    • 4
  • Hongliang Yi
    • 1
    Email author
  • Jian Guan
    • 1
    Email author
  • Shankai Yin
    • 1
  • Weiping Jia
    • 3
    • 4
  1. 1.Department of OtolaryngologyShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina
  2. 2.Department of General SurgeryShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina
  3. 3.Department of Endocrinology and MetabolismShanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina
  4. 4.Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes MellitusShanghai Key Clinical Center for Metabolic DiseaseShanghaiChina

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