Cho Jae Hoon, Choi Ji Ho, Suh Jeffrey D, Ryu Seungho, Cho Seok Hyun
Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University College of Medicine, Seoul, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
Clin Exp Otorhinolaryngol. 2016 Mar;9(1):1-7. doi: 10.21053/ceo.2016.9.1.1. Epub 2016 Mar 7.
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.
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).
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).
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.
肥胖被认为是阻塞性睡眠呼吸暂停（OSA）最重要的危险因素之一，但关于种族在OSA中的作用知之甚少。本研究的目的是调查OSA中肥胖相关表型的种族间差异，并揭示种族在OSA中的作用。
我们使用关键词“睡眠呼吸暂停”“体重指数”“颈围”“腰围”“腰臀比”等在MEDLINE、LILACS、Scopus和Cochrane图书馆进行检索。纳入标准为18岁以上成年人，以及包括多导睡眠图、肥胖相关参数且患者人群种族划分明确的研究。纳入的研究由2名独立评审员进行审查。收集对照组和OSA患者的以下信息：数量、年龄、性别、国家、种族（亚洲人或白种人）、研究设计、呼吸暂停低通气指数/呼吸紊乱指数、体重指数（BMI）、颈围（NC）、腰围（WC）和/或腰臀比（WHR）。
共检索到8312篇文献，随后有19篇手稿符合选择标准。共纳入2966例患者进行分析。主要结果如下：在考虑发表偏倚后，OSA患者和对照组在BMI、WC和WHR方面无差异；OSA患者的NC大于对照组（标准平均差，0.89；95%置信区间，0.63至1.14）；亚洲和白种人患者的NC无差异（P = 0.178）。
OSA可能与BMI、WC和WHR无关。只有NC与OSA有很强的关联，且这一发现在亚洲人和白种人之间没有差异。
