Tangugsorn V, Krogstad O, Espeland L, Lyberg T
Department of Orthodontics, Institute of Clinical Dentistry, University of Oslo, Norway.
Angle Orthod. 2001 Feb;71(1):23-35. doi: 10.1043/0003-3219(2001)071<0023:OSAACC>2.0.CO;2.
One hundred male obstructive sleep apnea (OSA) patients were classified into 2 groups on the basis of body mass index (BMI): 43 nonobese (BMI < 30 kg/m2) and 57 obese (BMI > or = 30 kg/m2) patients. A comprehensive cephalometric analysis with a multivariate statistical method was performed in order to define the different principal components (PCs) of cervico-craniofacial skeletal and upper airway soft tissue morphology in each group and how they contributed to selected elements of the patient demographic data, ie, apnea-hypopnea index (AHI), nocturnal oxyhemoglobin saturation, and BMI. Thirty cephalometric variables of cervico-craniofacial skeletal morphology were reduced to 8 PCs describing 84.4% and 85.4% of the total variance in obese and nonobese OSA patients, respectively. Sixteen cephalometric variables of hyoid bone position and head posture were reduced to 4 PCs describing 84.4% and 85.9% of the total variance in obese and nonobese OSA patients, respectively. Twenty cephalometric variables of upper airway soft tissue morphology were reduced to 7 PCs describing 89.5% and 84.6% of the total variance in obese and nonobese OSA patients, respectively. For further analysis of PCs, a stepwise multiple regression analysis was chosen. Two dependent variables of interest are the minimal distance of the posterior pharyngeal airway space (PASmin) and AHI. PASmin accounted for 95.3% (obese OSA group) and 74.3% (nonobese OSA group) with 7 PCs and AHI for 46% with 3 PCs in both groups. Three canonical variables and their correspondents with different loadings were established differently for both OSA groups. A canonical correlation successfully clarified the complexity of simultaneous relationship of the relevant variables. These analyses are proved useful to demonstrate the relationship of cervico-craniofacial skeletal and upper airway soft tissue morphology and selected demographic data. This lays down a basis for understanding the complicated pathogenic components of obese and nonobese OSA patients.
100名男性阻塞性睡眠呼吸暂停（OSA）患者根据体重指数（BMI）分为两组：43名非肥胖患者（BMI < 30 kg/m²）和57名肥胖患者（BMI ≥ 30 kg/m²）。采用多变量统计方法进行全面的头影测量分析，以确定每组中颈颅面部骨骼和上气道软组织形态的不同主成分（PCs），以及它们如何影响患者人口统计学数据的选定要素，即呼吸暂停低通气指数（AHI）、夜间氧合血红蛋白饱和度和BMI。颈颅面部骨骼形态的30个头影测量变量分别简化为8个PCs，分别描述了肥胖和非肥胖OSA患者总方差的84.4%和85.4%。舌骨位置和头部姿势的16个头影测量变量分别简化为4个PCs，分别描述了肥胖和非肥胖OSA患者总方差的84.4%和85.9%。上气道软组织形态的20个头影测量变量分别简化为7个PCs，分别描述了肥胖和非肥胖OSA患者总方差的89.5%和84.6%。为了进一步分析PCs，选择了逐步多元回归分析。两个感兴趣的因变量是咽后气道空间的最小距离（PASmin）和AHI。在两组中，PASmin分别由7个PCs解释了95.3%（肥胖OSA组）和74.3%（非肥胖OSA组），AHI由3个PCs解释了46%。为两个OSA组分别建立了三个具有不同载荷的典型变量及其对应变量。典型相关性成功地阐明了相关变量同时关系的复杂性。这些分析被证明有助于证明颈颅面部骨骼和上气道软组织形态与选定人口统计学数据之间的关系。这为理解肥胖和非肥胖OSA患者复杂的致病成分奠定了基础。
