Decrease of Plasma Soluble (Pro)renin Receptor by Bariatric Surgery in Patients with Obstructive Sleep Apnea and...

Area of Science:

• Endocrinology and Metabolism
• Sleep Medicine
• Nephrology

Background:

• Elevated plasma soluble (pro)renin receptor [s(P)RR] levels are observed in obstructive sleep apnea (OSA) patients.
• The impact of bariatric surgery on s(P)RR in morbidly obese individuals with OSA remains uninvestigated.
• This study addresses the gap in understanding s(P)RR dynamics following bariatric intervention in this specific patient cohort.

Purpose of the Study:

• To evaluate the effect of bariatric surgery on plasma s(P)RR concentrations in patients with morbid obesity and OSA.
• To identify factors associated with changes in plasma s(P)RR levels post-bariatric surgery.

Main Methods:

• A cohort of 23 patients with OSA and morbid obesity (without chronic kidney disease) underwent bariatric surgery.
• Overnight polysomnography (PSG) was conducted pre-surgery and at 4 and 24 weeks post-surgery.
• Plasma s(P)RR concentrations were measured daily after PSG.

Main Results:

• Preoperative s(P)RR levels positively correlated with serum creatinine, arousal index, apnea-hypopnea index (AHI), apnea index, and desaturation index, and inversely with estimated glomerular filtration rate.
• Plasma s(P)RR concentrations significantly decreased from 15.3 ± 3.6 ng/mL pre-surgery to 12.5 ± 2.7 ng/mL at 4 weeks and 11.4 ± 2.4 ng/mL at 24 weeks post-surgery.
• Post-surgery, the association between s(P)RR and PSG parameters was no longer significant.

Conclusions:

• Bariatric surgery effectively reduces plasma s(P)RR concentrations in patients with OSA and morbid obesity.
• The primary factors influencing these reductions were improvements in arousal index, AHI, apnea index, and desaturation index.
• These findings suggest a link between OSA severity and s(P)RR regulation, modifiable by bariatric surgery.