Tom Chloe, Roy Bhaswati, Vig Ruchi, Kang Daniel W, Aysola Ravi S, Woo Mary A, Harper Ronald M, Kumar Rajesh
Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA 90095, USA.
UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA 90095, USA.
Sleep Vigil. 2018 Dec;2(2):111-118. doi: 10.1007/s41782-018-0041-1. Epub 2018 May 15.
The body mass index (BMI), an estimate of body fat, provides a rather imprecise indication of risk for obstructive sleep apnea (OSA). We examined whether other measures, including waist and neck circumference, provide improved indicators of risk in treatment-naïve OSA subjects.
We studied 59 OSA subjects [age, 48.8±10.0 years; BMI, 31.9±6.6 kg/m; apnea-hypopnea-index (AHI), 38.5±23.0 events/hour; sleep efficiency index (SEI, n=52), 78.6±14.4%; lowest oxygen saturation (SaO nadir), 79.5±8.0%; systolic blood pressure (BP), 127.4±15.7 mmHg; diastolic BP, 80.1±9.1 mmHg; 43 male), and determined waist and neck circumferences (waist, 107.4±15.3 cm; neck, 41.8±4.7 cm), daytime sleepiness [Epworth sleepiness scale (ESS), 8.7±4.6], sleep quality [Pittsburgh sleep quality index (PSQI), 8.5±4.1], depression levels [Beck depression inventory II (BDI-II), 6.6±5.7), and anxiety levels [Beck anxiety inventory (BAI), 6.2±7.2]. We used partial correlation procedures (covariates, age and gender) to examine associations between BMI, waist, and neck circumferences vs. AHI, sleep, and neuropsychological variables.
BMI, waist, and neck circumferences were significantly correlated with SaO nadir (BMI; r=-0.423, p=0.001; waist; r=-0.457, p<0.001; neck; r=-0.263, p=0.048), AHI (BMI; r=0.349, p=0.008; waist; r=0.459, p<0.001; neck; r=0.276, p=0.038), and systolic BP (BMI; r=0.354, p=0.007; waist; r=0.321, p=0.015; neck; r=0.388, p=0.003). SEI was significantly correlated with waist circumference (r=0.28, p=0.049), but higher with BMI (r=0.291, p=0.04).
No other significant waist or neck correlations emerged. This study suggests that waist and neck measures correlate better than BMI with select disease severity (SaO nadir and AHI) in OSA subjects. The findings offer an easily-measured, ancillary means to assess OSA risk.
体重指数（BMI）作为一种身体脂肪的评估指标，对阻塞性睡眠呼吸暂停（OSA）风险的指示相当不准确。我们研究了包括腰围和颈围在内的其他指标是否能为未经治疗的OSA患者提供更好的风险指标。
我们研究了59名OSA患者[年龄，48.8±10.0岁；BMI，31.9±6.6kg/m²；呼吸暂停低通气指数（AHI），38.5±23.0次/小时；睡眠效率指数（SEI，n = 52），78.6±14.4%；最低血氧饱和度（SaO₂最低点），79.5±8.0%；收缩压（BP），127.4±15.7mmHg；舒张压，80.1±9.1mmHg；43名男性]，并测量了腰围和颈围（腰围，107.4±15.3cm；颈围，41.8±4.7cm）、日间嗜睡程度[爱泼沃斯嗜睡量表（ESS），8.7±4.6]、睡眠质量[匹兹堡睡眠质量指数（PSQI），8.5±4.1]、抑郁水平[贝克抑郁量表第二版（BDI-II），6.6±5.7]和焦虑水平[贝克焦虑量表（BAI），6.2±7.2]。我们使用偏相关程序（协变量为年龄和性别）来研究BMI、腰围和颈围与AHI、睡眠及神经心理变量之间的关联。
BMI、腰围和颈围与SaO₂最低点显著相关（BMI；r = -0.423，p = 0.001；腰围；r = -0.457，p < 0.001；颈围；r = -0.263，p = 0.048）、AHI（BMI；r = 0.349，p = 0.008；腰围；r = 0.459，p < 0.001；颈围；r = 0.276，p = 0.038）和收缩压（BMI；r = 0.354，p = 0.007；腰围；r = 0.321，p = 0.015；颈围；r = 0.388，p = 0.003）。SEI与腰围显著相关（r = 0.28，p = 0.049），但与BMI的相关性更高（r = 0.291，p = 方程求解0.04）。
未发现腰围或颈围与其他指标有其他显著相关性。本研究表明，在OSA患者中，腰围和颈围测量值与特定疾病严重程度（SaO₂最低点和AHI）的相关性优于BMI。这些发现提供了一种易于测量的辅助手段来评估OSA风险。
