DOI QR코드

DOI QR Code

Anthropometric Characteristics of Korean Patients with Obstructive Sleep Apnea

  • Cho, Jae Hoon (Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Konkuk University) ;
  • Choi, Ji Ho (Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital) ;
  • Lee, Bora (Department of Biostatistics, Soonchunhyang University Bucheon Hospital) ;
  • Mun, Sue-Jean (Department of Otorhinolaryngology, Pusan National University Yangsan Hospital) ;
  • Bae, Woo Yong (Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Dong-A University) ;
  • Kim, Sung Wan (Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School, Kyung Hee University) ;
  • Cho, Seok Hyun (Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University)
  • Received : 2017.12.18
  • Accepted : 2018.04.16
  • Published : 2018.11.30

Abstract

Background and Objectives: Obesity is one of the most important risk factors for obstructive sleep apnea (OSA). There is limited evidence regarding the obesity-related anthropometric characteristics of Korean patients. Materials and Method: Medical records of 984 patients referred to 3 tertiary referral hospitals for habitual snoring or sleep apnea were analyzed. We defined OSA as apnea-hypopnea index (AHI) ${\geq}5$ and analyzed data to determine the anthropometric characteristics of patients with OSA such as neck circumference (NC), waist circumference (WC), hip circumference (HC), and waist to hip ratio (WHR). Results: A total of 952 patients (719 men) were included in the analysis. The main findings were: 1) BMI, WC, NC, HC, and WHR were greater among patients with OSA than among controls (AHI <5); 2) for both sexes, the proportion of patients with an OSA diagnosis increased with age; it increased steeply for women aged >50 years; 3) WC and WHR were most strongly correlated with AHI for men and women, respectively. Conclusion: OSA is associated with anthropometric characteristics, although different patterns were observed between men and women. OSA was more strongly associated with NC or WC among men and with WHR among women.

Keywords

References

  1. Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, et al. Clinical guideline for the evaluation, management and longterm care of obstructive sleep apnea in adults. J Clin Sleep Med 2009;5(3):263-76.
  2. Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R5, Ramar K, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 2017;13(3):479-504. https://doi.org/10.5664/jcsm.6506
  3. Namyslowski G, Scierski W, Mrowka-Kata K, Kawecka I, Kawecki D, Czecior E. Sleep study in patients with overweight and obesity. J Physiol Pharmacol 2005;56 Suppl 6:59-65.
  4. Ip MS, Lam KS, Ho C, Tsang KW, Lam W. Serum leptin and vascular risk factors in obstructive sleep apnea. Chest 2000;118:580-6. https://doi.org/10.1378/chest.118.3.580
  5. Yucel A, Unlu M, Haktanir A, Acar M, Fidan F. Evaluation of the upper airway cross-sectional area changes in different degrees of severity of obstructive sleep apnea syndrome: cephalometric and dynamic CT study. Am J Neuroradiol 2005;26:2624-9.
  6. Julia-Serda G, Perez-Penate G, Saavedra-Santana P, Ponce-Gonzalez M, Valencia-Gallardo JM, Rodriguez-Delgado R, et al. Usefulness of cephalometry in sparing polysomnography of patients with suspected obstructive sleep apnea. Sleep Breath 2006;10:181-7. https://doi.org/10.1007/s11325-006-0073-y
  7. Zhao ZH, Sullivan C, Liu ZH, Luo Q, Xiong CM, Ni XH, et al. Prevalence and clinical characteristics of sleep apnea in Chinese patients with heart failure. Int J Cardiol 2007;118:122-3. https://doi.org/10.1016/j.ijcard.2006.06.031
  8. Sharma SK, Kumpawat S, Goel A, Banga A, Ramakrishnan L, Chaturvedi P. Obesity, and not obstructive sleep apnea, is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing. Sleep Med 2007;8:12-7. https://doi.org/10.1016/j.sleep.2006.06.014
  9. Liu KH, Chu WC, To KW, Ko FW, Tong MW, Chan JW, et al. Sonographic measurement of lateral parapharyngeal wall thickness in patients with obstructive sleep apnea. Sleep 2007;30:1503-8. https://doi.org/10.1093/sleep/30.11.1503
  10. Martinez-Rivera C, Abad J, Fiz JA, Rios J, Morera J. Usefulness of truncal obesity indices as predictive factors for obstructive sleep apnea syndrome. Obesity 2008;16:113-8. https://doi.org/10.1038/oby.2007.20
  11. Nakagawa Y, Kishida K, Kihara S, Sonoda M, Hirata A, Yasui A, et al. Nocturnal reduction in circulating adiponectin concentrations related to hypoxic stress in severe obstructive sleep apnea-hypopnea syndrome. Am J Physiol Endocrinol Metab 2008;294:E778-84. https://doi.org/10.1152/ajpendo.00709.2007
  12. Jelic S, Lederer DJ, Adams T, Padeletti M, Colombo PC, Factor PH, et al. Vascular inflammation in obesity and sleep apnea. Circulation 2010;121:1014-21. https://doi.org/10.1161/CIRCULATIONAHA.109.900357
  13. Angelico F, del Ben M, Augelletti T, de Vita R, Roma R, Violi F, et al. Obstructive sleep apnoea syndrome and the metabolic syndrome in an internal medicine setting. Eur J Intern Med 2010;21:191-5. https://doi.org/10.1016/j.ejim.2010.03.006
  14. Ugur KS, Ark N, Kurtaran H, Kizilbulut G, Cakir B, Ozol D, et al. Subcutaneous fat tissue thickness of the anterior neck and umbilicus in patients with obstructive sleep apnea. Otolaryngol Head Neck Surg 2011;145:505-10. https://doi.org/10.1177/0194599811410272
  15. Kawaguchi Y, Fukumoto S, Inaba M, Koyama H, Shoji T, Shoji S, et al. Different impacts of neck circumference and visceral obesity on the severity of obstructive sleep apnea syndrome. Obesity 2011;19:276-82. https://doi.org/10.1038/oby.2010.170
  16. Soylu AC, Levent E, Sariman N, Yurtlu S, Alparslan S, Saygi A. Obstructive sleep apnea syndrome and anthropometric obesity indexes. Sleep Breath 2012;16:1151-8. https://doi.org/10.1007/s11325-011-0623-9
  17. Lubrano C, Saponara M, Barbaro G, Specchia P, Addessi E, Costantini D, et al. Relationships between body fat distribution, epicardial fat and obstructive sleep apnea in obese patients with and without metabolic syndrome. PLoS One 2012;7:e47059. https://doi.org/10.1371/journal.pone.0047059
  18. Lin QC, Zhang XB, Chen GP, Huang DY, Din HB, Tang AZ. Obstructive sleep apnea syndrome is associated with some components of metabolic syndrome in nonobese adults. Sleep Breath 2012;16:571-8. https://doi.org/10.1007/s11325-011-0544-7
  19. Apaydin M, Ayik SO, Akhan G, Peker S, Uluc E. Carotid intimamedia thickness increase in patients with habitual simple snoring and obstructive sleep apnea syndrome is associated with metabolic syndrome. J Clin Ultrasound 2013;41:290-6. https://doi.org/10.1002/jcu.22040
  20. Liu KH, Chu WC, To KW, Ko FW, Ng SS, Ngai JC, et al. Mesenteric fat thickness is associated with increased risk of obstructive sleep apnoea. Respirology 2014;19:92-7.
  21. Banhiran W, Junlapan A, Assanasen P, Chongkolwatana C. Physical predictors for moderate to severe obstructive sleep apnea in snoring patients. Sleep Breath 2014;18:151-8. https://doi.org/10.1007/s11325-013-0863-y
  22. Lim YH, Choi J, Kim KR, Shin J, Hwang KG, Ryu S, et al. Sex-specific characteristics of anthropometry in patients with obstructive sleep apnea: Neck circumference and waist-hip ratio. Ann Otol Rhinol Laryngol 2014;25:517-23.
  23. Lee SK, Kim SW, Lee YC, Kim SH, Eun YG, Cho JS. Difference of Polysomnographic, Anthropometric, Physical and Radiologic Findings in an Obstructive Sleep Apnea Syndrome Patient with Excessive Daytime Sleepiness. J Rhinol 2008;15(1):55-61.
  24. Cho JH, Choi JH, Suh JD, Ryu S, Cho SH. Comparison of anthropometric data between Asian and Caucasian patients with obstructive sleep apnea: a meta-analysis. Clin Exp Otorhinolaryngol 2016;9(1):1-7. https://doi.org/10.21053/ceo.2016.9.1.1
  25. Chung YS, Jang YJ, Lee BJ, Lee SA, Choi SJ, Kang WS, et al. Gender Differences of Polysomnographic Findings in Snoring Patients. J Rhinol 2004;11(1):48-51.
  26. Kim IK, Choi HM, Kim MH. Menopausal Knowledge and Management in Peri-menopausal Women. J Korean Soc Menopause 2012;18:124-31. https://doi.org/10.6118/jksm.2012.18.2.124

Cited by

  1. Gender-Specific Associations of Different Anthropometric Indices with Sleep Quality and Daytime Sleepiness vol.13, pp.1, 2020, https://doi.org/10.2174/1874944502013010273