Polesel Daniel Ninello, Nozoe Karen Tieme, Tufik Sergio Brasil, Bezerra Andreia Gomes, Fernandes Maria Teresa Bechere, Bittencourt Lia, Tufik Sergio, Andersen Monica Levy, Hachul Helena
Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil.
Universidade de São Paulo, Departamento de Pediatria - São Paulo - São Paulo - Brazil.
Sleep Sci. 2019 Jan-Feb;12(1):2-9. doi: 10.5935/1984-0063.20190048.
This study aims to investigate anthropometric measures and their effectiveness as screening method for diagnosing obstructive sleep apnea (OSA) in each gender. We also evaluated which measures were associated with OSA in the adult population of a large metropolitan city, Sao Paulo, Brazil. 552 women and 450 men were submitted to polysomnography (PSG), and the anthropometric measurements as body mass index (BMI), waist-to-height ratio, neck and waist circumference were collected. The measurements were then compared with the OSA classification established by the PSG. In women, waist circumference and waist-to-height ratio were found to be the best predictor, while in men, the factors with great potential for identification varied according to severity of the disease, highlighting waist-to-height ratio, neck circumference and BMI had strongest association. The accuracy of the classification in relation to mild-to-severe OSA based on cut-off values of 92.5cm for waist circumference was greater than 72.9% in men, and 78.9% in women based on cut off values of 95cm. Regarding severe OSA, cut-off values of 116.1cm were greater than 91.3% accurate in the male population, and 95.1% in the female population with a cut-off value of 126.5cm. The study found waist circumference and waist-to-height ratio to be the best measure to assess sleep-disordered breathing in women. Waist-to-height ratio and neck circumferences were the best measures in men with mild OSA, but BMI was more closely associated with severe OSA. The present study identified the anthropometric variables with the highest risk for OSA and their respective cutoff value, according to gender.
本研究旨在调查人体测量指标及其作为各性别阻塞性睡眠呼吸暂停(OSA)诊断筛查方法的有效性。我们还评估了在巴西圣保罗这个大都市的成年人群中,哪些指标与OSA相关。552名女性和450名男性接受了多导睡眠图(PSG)检查,并收集了人体测量数据,如体重指数(BMI)、腰高比、颈围和腰围。然后将这些测量值与PSG确定的OSA分类进行比较。在女性中,腰围和腰高比被发现是最佳预测指标,而在男性中,具有很大识别潜力的因素因疾病严重程度而异,突出显示腰高比、颈围和BMI的关联最强。基于腰围92.5厘米的临界值,男性中轻度至重度OSA分类的准确率高于72.9%,女性基于95厘米的临界值准确率为78.9%。对于重度OSA,男性中116.1厘米的临界值准确率高于91.3%,女性中126.5厘米的临界值准确率为95.1%。研究发现腰围和腰高比是评估女性睡眠呼吸障碍的最佳指标。腰高比和颈围是轻度OSA男性的最佳指标,但BMI与重度OSA的关联更密切。本研究根据性别确定了OSA风险最高的人体测量变量及其各自的临界值。