Matarredona-Quiles Silvia, Carrasco-Llatas Marina, Martínez-Ruíz de Apodaca Paula, Díez-Ares José Ángel, González-Turienzo Elena, Dalmau-Galofre José
Department of Otorhinolaryngology, Head and Neck Surgery, Doctor Peset University Hospital, Valencia, Spain.
Department of Otorhinolaryngology, Head and Neck Surgery, Hospital IMED Valencia y Colón, Burjassot, Spain.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5126-5132. doi: 10.1007/s12070-024-04908-0. Epub 2024 Aug 1.
Objectives: To determine if there are clinical or anatomical differences between patients with grade II-IV obesity without obstructive sleep apnea (OSA) or mild OSA and patients with moderate or severe OSA and to assess whether any of these factors are predictive of moderate/severe OSA. Methods: Observational case-control study with consecutive sampling including patients between 18 and 65 years of age with grade II-IV obesity who were candidates for bariatric surgery. An anamnesis regarding OSA symptoms, a physical examination of the upper airway and a cardiorespiratory polygraphy were performed. Results: A total of 124 patients were included in the study, of whom 61.3% did not have OSA or had mild OSA and 38.7% had moderate or severe OSA. Age over 48 years was the only independent factor associated with moderate or severe OSA. Other factors showed a relation with moderate/severe OSA after multivariate analysis: male sex, STOP-BANG questionnaire ≥ 3, weight ≥ 105 kg, thick neck, neck circumference ≥ 41.25 cm, flaccid palate, Mallampati III-IV index, Friedman tongue position III-IV and retropalatal narrowing. Conclusions: The only independent predictive factor related to moderate or severe OSA in patients with morbid obesity was age over 48 years, therefore a sleep study remains essential for its diagnosis.
The online version contains supplementary material available at 10.1007/s12070-024-04908-0.
目的：确定无阻塞性睡眠呼吸暂停（OSA）或轻度OSA的II-IV级肥胖患者与中度或重度OSA患者之间是否存在临床或解剖学差异，并评估这些因素中是否有任何因素可预测中度/重度OSA。方法：采用连续抽样的观察性病例对照研究，纳入年龄在18至65岁之间、适合进行减肥手术的II-IV级肥胖患者。进行了关于OSA症状的问诊、上气道体格检查和心肺多导睡眠图检查。结果：共纳入124例患者，其中61.3%无OSA或患有轻度OSA，38.7%患有中度或重度OSA。48岁以上是与中度或重度OSA相关的唯一独立因素。多因素分析后，其他因素与中度/重度OSA有关：男性、STOP-BANG问卷评分≥3、体重≥105 kg、颈部粗壮、颈围≥41.25 cm、软腭松弛、Mallampati III-IV级、Friedman舌位III-IV级和腭后狭窄。结论：病态肥胖患者中与中度或重度OSA相关的唯一独立预测因素是48岁以上，因此睡眠研究对于其诊断仍然至关重要。
在线版本包含可在10.1007/s12070-024-04908-0获取的补充材料。
