Objectives: To evaluate the available evidence on the metabolic outcomes of obstructive sleep apnea (OSA) surgery and identify gaps in the current literature.

Data sources: A literature search was performed using PubMed, Embase, Web of Science, and Cochrane Library databases.

Review methods: Search strategy was developed with a senior informationist at our institution. Metabolic measures of interest included insulin resistance, fasting glucose, hemoglobin A1C (HbA1c), inflammatory markers, adipokines, lipid profiles, and body mass index (BMI). Title, abstract, and full-text screening were performed by three reviewers with subsequent narrative synthesis.

Results: 3484 studies were initially identified, with 160 meeting inclusion criteria. 129 studies were included solely due to reporting of pre- and post-operative BMIs. The remaining 31 studies (n = 1675 participants) examined other metabolic outcomes and included various categories of OSA surgery: soft tissue surgery alone (58.1%) or in combination with nasal or skeletal surgery (32.3%), upper airway stimulation (6.5%), and skeletal surgery alone (3.2%). Within the 31 studies, the most commonly examined metabolic outcomes were C-reactive protein (CRP, 45.1%), lipid profiles (45.1%), TNF-α and IL-6 (25.8%), fasting glucose (25.8%), leptin (22.6%), HbA1c (19.4%), and insulin resistance (16.1%). Most studies demonstrated improvements in CRP, TNF-α, IL-6, and leptin, but no changes in fasting glucose, insulin resistance, or HbA1c. None of the included studies examined BMI as a primary outcome.

Conclusions: The existing literature suggests that OSA surgery is associated with improvements in inflammatory markers. The paucity of studies on the metabolic outcomes of upper airway stimulation and skeletal surgery highlights knowledge gaps for these OSA surgeries.

Keywords: adipokines; cardiometabolic outcomes; hypoglossal nerve stimulation; inflammatory cytokines; insulin resistance; lipid profiles; metabolic health; obstructive sleep apnea surgery.

© 2025 The American Laryngological, Rhinological and Otological Society, Inc.

目标： 评估阻塞性睡眠呼吸暂停（OSA）手术代谢结局的现有证据，并识别当前文献中的不足之处。

数据来源： 使用PubMed、Embase、Web of Science和Cochrane Library数据库进行了文献检索。

回顾方法： 在我们机构的一位资深信息员的协助下制定了搜索策略。感兴趣的代谢指标包括胰岛素抵抗、空腹血糖、糖化血红蛋白（HbA1c）、炎症标志物、脂肪因子、血脂谱和体重指数（BMI）。三位审稿人进行了标题、摘要及全文筛选，随后进行叙述性综合分析。

结果： 最初确定了3484项研究，其中160项符合纳入标准。有129项研究仅因报告术前和术后BMI而被包括在内。剩余的31项研究（共1675名参与者）探讨了其他代谢结局，并涵盖了各种OSA手术类别：单独软组织手术（58.1%）或与鼻部或骨骼手术结合（32.3%）、上气道刺激（6.5%）和单独骨骼手术（3.2%）。在这31项研究中，最常见的代谢指标是C反应蛋白（CRP，45.1%）、血脂谱（45.1%）、TNF-α 和 IL-6（25.8%）、空腹血糖（25.8%）、瘦素（22.6%）、HbA1c（19.4%）和胰岛素抵抗（16.1%）。大多数研究显示CRP、TNF-α、IL-6 和瘦素有所改善，但没有发现空腹血糖、胰岛素抵抗或 HbA1c 的变化。所纳入的研究均未将BMI作为主要结局进行考察。

结论： 现有文献表明OSA手术与炎症标志物的改善相关。关于上气道刺激和骨骼手术代谢结果的研究不足，突显了这些OSA手术知识上的空白。

关键词： 脂肪因子；心肺代谢结局；舌下神经刺激；炎性细胞因子；胰岛素抵抗；血脂谱；代谢健康；阻塞性睡眠呼吸暂停手术。