J Rhinol.  2018 Nov;25(2):80-85. 10.18787/jr.2018.25.2.80.

Anthropometric Characteristics of Korean Patients with Obstructive Sleep Apnea

• Cho JH
• Choi JH
• Lee B
• Mun SJ
• Bae WY
• Kim SW
• Cho SH

• KMID: 2431220
• DOI: http://doi.org/10.18787/jr.2018.25.2.80

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) ≥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.

Keyword

obstructive sleep apnea; Body mass index; Neck circumference; Waist circumference; Waist to hip ratio

MeSH Terms

Body Mass Index
Diagnosis
Female
Hip
Humans
Male
Medical Records
Methods
Neck
Obesity
Risk Factors
Sleep Apnea Syndromes
Sleep Apnea, Obstructive*
Snoring
Tertiary Care Centers
Waist Circumference
Waist-Hip Ratio

Figure

• 

  Fig. 1 Frequency of obstructive sleep apnea according to sex and age.

• 

  Fig. 2 ROC curves of anthropometric variables for obstructive sleep apnea in men and women.

Reference

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.

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.

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). Julià-Serdà G., Pérez-Peñate G., Saavedra-Santana P., Ponce-González M., Valencia-Gallardo JM., Rodríguez-Delgado R, et al. Usefulness of cephalometry in sparing polysomnography of patients with suspected obstructive sleep apnea. Sleep Breath. 2006. 10:181–7.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

19). Apaydin M., Ayik SO., Akhan G., Peker S., Uluc E. Carotid intima-media 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.

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.

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.

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.