Wang Yan-jiao, Yang Yu, Liu You-shuo, Luo Ying-quan, Wang Yi-na, Fu Liu-ying
Department of Geriatrics, 2nd Xiangya Hospital of Central-south University, Changsha, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2007 Oct;28(10):1021-5.
To determine the best cutoff value and reference standard of obese indexes and to compare their diagnostic value in screening, predicting and diagnosing obstructive sleep apnea-hypopnea syndrome (OSAHS) in male adults by receiver operating characteristic curve (ROC).
A total of 1110 male adults were included and cross-sectional study was adopted. Four parameters including: body mass index (BMI), neck circumference (NC), waist circumference (WC) and waist-to-hip ratio (WHR) were studied. The correlativity between apnea-hypopnea index (AHI) and BMI, NC, WC and WHR were analyzed by pearson correlation test. ROC curve was used to assess the diagnostic value and determine their best cutoff value to predict OSAHS and reference standard to screen/diagnose it. Their conformity in predicting OSAHS was analyzed by area under curve (AUC). SPSS software version 13.0 was used for statistical analysis and P< or =0.05 was considered to indicate statistical significance.
(1) All of the fourindexes (BMI, NC, WC and WHR) showed a significantly positive correlation with AHI in adult male patients, with their Pearson coefficients as 0.373, 0.276, 0.291 and 0.127, respectively, and their P value were all below 0.001; (2) The best cutoff value of BMI, NC and WC in predicting OSAHS were 26.5 kg/m2 , 39 cm, 95 cm, and their corresponding sensitivity rates were 54%, 57% and 64% while rates of specificity as 73%, 65% and 53%; (3) BMI was better than other two indexes in predicting OASHS in adult male patients; (4) The value of BMI, NC and WC in screening OSAHS among adult male patients with 90% sensitivity and 10% rate of missed diagnosis as 23 kg/m2, 35 cm, 85 cm; (5) The value of BMI, NC and WC in screening OSAHS in adult male patients with 90% specificity and 10% misdiagnosis rate as 29 kg/m2, 43 cm, 105 cm, respectively.
BMI seemed better in predicting OSAHS in male adults than NC, WC and WHR. The best cutoff values to predict OSAHS of BMI, NC and WC were 26.5 kg/m2, 39 cm and 95 cm, respectively. Their reference standards to screen OSAHS were 23 kg/m2, 35 cm and 85 cm while 29 kg/m2, 43 cm and 105 cm to predict OSAHS.
通过绘制受试者工作特征曲线（ROC）来确定肥胖指标的最佳截断值和参考标准，并比较其在成年男性阻塞性睡眠呼吸暂停低通气综合征（OSAHS）筛查、预测和诊断中的诊断价值。
纳入1110名成年男性，采用横断面研究。研究了包括体重指数（BMI）、颈围（NC）、腰围（WC）和腰臀比（WHR）在内的四个参数。通过Pearson相关性检验分析呼吸暂停低通气指数（AHI）与BMI、NC、WC和WHR之间的相关性。采用ROC曲线评估诊断价值，确定其预测OSAHS的最佳截断值和筛查/诊断的参考标准。通过曲线下面积（AUC）分析它们在预测OSAHS方面的一致性。使用SPSS 13.0软件进行统计分析，P≤0.05被认为具有统计学意义。
（1）在成年男性患者中，所有四个指标（BMI、NC、WC和WHR）与AHI均呈显著正相关，其Pearson系数分别为0.373、0.276、0.291和0.127，P值均低于0.001；（2）BMI、NC和WC预测OSAHS的最佳截断值分别为26.5kg/m²、39cm、95cm，相应的敏感度分别为54%、57%和64%，特异度分别为73%、65%和53%；（3）在成年男性患者中，BMI在预测OSAHS方面优于其他两个指标；（4）BMI、NC和WC在成年男性患者中筛查OSAHS且敏感度为90%、漏诊率为10%时的值分别为23kg/m²、35cm、85cm；（5）BMI、NC和WC在成年男性患者中筛查OSAHS且特异度为90%、误诊率为10%时的值分别为29kg/m²、43cm、105cm。
在成年男性中预测OSAHS方面，BMI似乎优于NC、WC和WHR。BMI、NC和WC预测OSAHS的最佳截断值分别为26.5kg/m²、39cm和95cm。它们筛查OSAHS的参考标准分别为23kg/m²、35cm和85cm，预测OSAHS的参考标准分别为29kg/m²、43cm和105cm。
