Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2 East Yinghua (Cherry Blossom) Road, Hepingli, Chaoyang District, Beijing, 100029, China.
Graduate School of Peking Union Medical College, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
BMC Pulm Med. 2022 Apr 22;22(1):151. doi: 10.1186/s12890-022-01886-3.
Adiposity is a well-established risk factor for obstructive sleep apnea (OSA), but whether a combination of preferable anthropometric measurements may improve the accuracy of detecting OSA is unknown. This study aimed to explore the accuracies of the waist-hip ratio (WHR) in conjunction with the body mass index (BMI) when identifying the severity of OSA.
A total of 2012 participants in the China-Japan Friendship Hospital from January 2018 to December 2019 underwent anthropometric measurements and an overnight home sleep test (HST). The 244 subjects who met the criteria for obstructive sleep apnea (apnea-hypopnea index (AHI) ≥ 5 events/hour) were divided into four groups: Group A (55 patients with WHR ≥ 0.9 and BMI ≥ 28 kg/m); Group B (12 patients with WHR < 0.9 and BMI ≥ 28 kg/m); Group C (69 patients with WHR ≥ 0.9 and BMI < 28 kg/m); and group D (108 patients with WHR < 0.9 and BMI < 28 kg/m).
The AHI, apnea index (AI), hypopnea index (HI), and oxygen desaturation index (ODI) were significantly different among the 4 groups (p < 0.05). The WHR was positively correlated with AHI (r = 0.22, p < 0.001), AI (r = 0.270, p = 0.004), and ODI (r = 0.286, p = 0.0022) and negatively correlated with lowest oxygen pulse saturation (LSpO) (r = 0.246, p = 0.008) only in nonobese patients. Moreover, the WHR was found to be a screening marker for moderate-to-severe OSA in Group D (p < 0.05). When used to identify severe OSA in Group D, the WHR cut-off point of 0.873 yielded a sensitivity of 65% and specificity of 56% (p < 0.05).
In nonobese male OSA patients, WHR is a moderate screening marker for moderate-to-severe OSA and an independent risk factor for OSA severity.
肥胖是阻塞性睡眠呼吸暂停（OSA）的一个既定危险因素，但多种理想的人体测量学指标的组合是否可以提高检测 OSA 的准确性尚不清楚。本研究旨在探讨腰臀比（WHR）与体重指数（BMI）联合用于识别 OSA 严重程度的准确性。
2018 年 1 月至 2019 年 12 月，共有 2012 名来自中日友好医院的参与者接受了人体测量和过夜家庭睡眠测试（HST）。符合阻塞性睡眠呼吸暂停标准（呼吸暂停-低通气指数（AHI）≥5 次/小时）的 244 名受试者被分为四组：A 组（55 名 WHR≥0.9 且 BMI≥28kg/m2）；B 组（12 名 WHR<0.9 且 BMI≥28kg/m2）；C 组（69 名 WHR≥0.9 且 BMI<28kg/m2）；和 D 组（108 名 WHR<0.9 且 BMI<28kg/m2）。
四组之间 AHI、呼吸暂停指数（AI）、低通气指数（HI）和氧减饱和度指数（ODI）差异有统计学意义（p<0.05）。WHR 与 AHI（r=0.22，p<0.001）、AI（r=0.270，p=0.004）和 ODI（r=0.286，p=0.0022）呈正相关，与最低血氧饱和度脉搏（LSpO）呈负相关（r=0.246，p=0.008），仅在非肥胖患者中如此。此外，在 D 组中，WHR 被发现是中重度 OSA 的筛查标志物（p<0.05）。当用于识别 D 组中的重度 OSA 时，WHR 截断值为 0.873 时，灵敏度为 65%，特异性为 56%（p<0.05）。
在非肥胖的男性 OSA 患者中，WHR 是中重度 OSA 的中度筛查标志物，也是 OSA 严重程度的独立危险因素。
