Clin Exp Otorhinolaryngol.  2016 Mar;9(1):1-7. 10.21053/ceo.2016.9.1.1.

Comparison of Anthropometric Data Between Asian and Caucasian Patients With Obstructive Sleep Apnea: A Meta-Analysis

• Cho JH
• Choi JH
• Suh JD
• Ryu S
• Cho SH

• KMID: 2166272
• DOI: http://doi.org/10.21053/ceo.2016.9.1.1

Abstract

OBJECTIVES
Obesity is considered to be one of the most important risk factors for obstructive sleep apnea (OSA) but less is known about the role of ethnicity in OSA. The purpose of this study was to investigate the interethnic difference of obesity-related phenotypes in OSA and to reveal the role of ethnicity in OSA.
METHODS
We searched MEDLINE, LILACS, Scopus, and the Cochrane Library using the key words "sleep apnea," "body mass index," "neck circumference," "waist circumference," "waist to hip ratio," etc. Inclusion criteria were adults over 18 years of age, and studies that included polysomnography, obesity-related parameters, and a clear demarcation of ethnicity in the patient population. Included studies were reviewed by 2 independent reviewers. The following information was collected for controls and OSA: number, age, gender, country, ethnicity (Asian or Caucasian), study design, apnea-hypopnea index/respiratory disturbance index, body mass index (BMI), neck circumference (NC), waist circumference (WC), and/or waist to hip ratio (WHR).
RESULTS
A total of 8,312 publications were retrieved with a subsequent 19 manuscripts that met the selection criteria. A total of 2,966 patients were included for analysis. The main findings were as follows: There was no difference in BMI, WC, and WHR between patients with OSA and controls after accounting for publication bias; Patients with OSA have greater NC than controls (standard mean difference, 0.89; 95% confidence interval, 0.63 to 1.14); and There was no difference in NC between Asian and Caucasians patients (P=0.178).
CONCLUSION
OSA might not be related with BMI, WC, and WHR. Only NC demonstrated a strong association with OSA, and this finding was not different between Asians and Caucasians.

Keyword

Sleep Apnea, Obstructive; Body Mass Index; Waist-Hip Ratio; Meta-Analysis; Obesity

MeSH Terms

Adult
Asian Continental Ancestry Group*
Body Mass Index
Hip
Humans
Neck
Obesity
Patient Selection
Phenotype
Polysomnography
Publication Bias
Risk Factors
Sleep Apnea, Obstructive*
Waist Circumference
Waist-Hip Ratio

Figure

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  Fig. 1. Search results.

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  Fig. 2. Forest plot for body mass index and neck circumference. OSA, obstructive sleep apnea; SMD, standard mean difference; CI, confidence inerval.

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  Fig. 3. Funnel plot for body mass index, neck circumference, waist circumference, and waist-hip ratio. SE, standard error.

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  Fig. 4. Forest plot for waist circumference and waist-hip ratio. OSA, obstructive sleep apnea; SMD, standard mean difference; CI, confidence inerval.

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