scholarly journals Relation between obstructive airway disease and body mass index, neck circumference in patients with obstructive sleep apnoea

Author(s):  
Samta Samta ◽  
H. Surynarayana ◽  
H. Chandrashekhar ◽  
Prasad L.
BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044228
Author(s):  
Henry Oliveros ◽  
Rafael Lobelo ◽  
Luis Fernando Giraldo-Cadavid ◽  
Alirio Bastidas ◽  
Constanza Ballesteros ◽  
...  

ObjectivesObstructive sleep apnoea (OSA)/hypopnoea syndrome is associated with serious and major multiorgan morbidities, particularly in its most severe forms. However, no severe OSA screening instruments are available for high altitude residents that enable adequate identification and clinical prioritisation of such patients. We aimed at developing a severe OSA prediction tool based on the clinical characteristics and anthropometric measurements of a clinical referral cohort living at 2640 m.a.s.l.DesignCohort-nested cross-sectional study.SettingSleep laboratory for standard polysomnography (PSG) in Colombia.ParticipantsA predictive model was generated from 8718 participants referred to the PSG laboratory. Results were subsequently validated in a second cohort of 1898 participants.Primary outcomeTo identify clinical and anthropometric variables associated with severe OSA (>30 events/hour) and to include them in a binary logistic regression model.ResultsThe significant variables that were retained with the presence of severe OSA included Body mass index (BMI), Age, Sex, Arterial hypertension and Neck circumference (BASAN). The area under the receiver operating characteristic curvefor the BASAN index was 0.69 (95% CI: 0.68 to 0.70) in the derivation cohort and 0.67 (95% CI: 0.65 to 0.69) in the validation cohort, whereby a BASAN index ≥2 had a sensitivity of 95% and a specificity of 17% to detect severe OSA.ConclusionAn objectively based approach to screen for the presence of severe OSA, the BASAN index, exhibits favourable sensitivity characteristics that should enable its operational use as a screening tool in a Hispanic population with a clinical suspicion of OSA and living at high altitude.


2020 ◽  
Vol 6 (2) ◽  
pp. 00101-2019 ◽  
Author(s):  
Hanna-Riikka Kreivi ◽  
Tuomas Itäluoma ◽  
Adel Bachour

IntroductionThe prevalence of obesity is continually increasing worldwide, which increases the incidence of obesity hypoventilation syndrome (OHS) and its consequent mortality.MethodsWe reviewed the therapy mode, comorbidity and mortality of all OHS patients treated at our hospital between 2005 and 2016. The control group consisted of randomly selected patients with obstructive sleep apnoea (OSA) treated during the same period.ResultsWe studied 206 OHS patients and 236 OSA patients. The OHS patients were older (56.3 versus 52.3 years, p<0.001) and heavier (body mass index 46.1 versus 32.2 kg·m−2, p<0.001), and the percentage of women was higher (41.2% versus 24.2%, p<0.001), respectively. The OHS patients had more hypertension (83% versus 61%, p<0.001) and diabetes (62% versus 31%, p<0.001) than the OSA patients, but no higher stroke (4% versus 8%, p=0.058) or ischaemic heart disease (14% versus 15%, p=0.437) incidence. The 5- and 10-year, unadjusted survival rates were lower among the OHS patients than among the OSA patients (83% versus 96% and 74% versus 91%, respectively; p<0.001). Differences in mortality rates were not related to age, sex or body mass index; covariates such as Charlson Comorbidity Index and ventilation therapy predicted survival. The mortality rate decreased significantly (p<0.001) both in OHS and OSA patients even after adjusting for covariates.ConclusionsThe mortality rate in OHS was significantly higher than that in OSA patients even after adjusting for covariates. Ventilation therapy by continuous positive airway pressure or noninvasive ventilation have reduced mortality significantly in all patients.


2021 ◽  
Vol 8 (2) ◽  
pp. 79-82
Author(s):  
Saurabh Mishra ◽  
G N Srivastava ◽  
J K Mishra ◽  
Ritamvara Oli

Obstructive sleep apnoea has very strong association with both body mass index and pulmonary hypertension. There is a paucity of data to relate BMI and PH in patients with OSA. To see the relation between body mass index and pulmonary hypertension in patients with obstructive sleep apnoea. Patients with symptoms of OSA were screened for polysomnography by using STOP-BANG criteria. 100 patients with AHI ≥5 with symptoms of obstructive sleep apnoea and AHI ≥ 15 without symptoms of obstructive sleep apnoea were selected for other investigations. Neck circumference was measured and BMI was calculated to estimate the severity of obstruction. PFT and chest X-ray were done to rule-out other respiratory illnesses. 2D-echocardiography was done for screening of pre-existing structural cardiac anomaly or any raise in pulmonary artery pressure. MRI neck was done to check neck muscles status. Out of 100 patients in study group 10% (n=10) had mild, 12% (n=12) had moderate and 78% (n=78) had severe OSA. Most of the patients belonged to overweight (52%) and obesity stage 1 (34%) groups. 10% and 2% of the patients belonged to obesity stage 2 and severe obesity groups respectively. Only 2% of the patients were healthy and none of the patients were underweight. PH was present in 24% (n=24) of cases, mild (n=10) and moderate (n=10) PH each were 10% and severe (n=4) PH was present in 4% of the cases. 100% of the patients with severe obesity had pulmonary hypertension. Most of the patients with PH belonged to Obesity grade 1 and overweight groups, whereas none of normal BMI patients had PH. Body mass index has indirect relation with pulmonary hypertension. In our study, we found that pulmonary hypertension was present only in overweight and obese patients. Whereas, none of the patients with normal BMI had pulmonary hypertension.


2020 ◽  
pp. 1-4
Author(s):  
Abdulmenem Abualsel ◽  
Abdulmenem Abualsel ◽  
Ashish Mhatre ◽  
Nalin Mathur ◽  
Susan Dovey

Introduction: There is currently a high prevalence of obesity in the Arabian Gulf yet relatively little research on bariatric surgery. In this study we investigate the efficacy of bariatric surgery in patients with super morbid obesity, defined as a Body Mass Index (BMI) of ≥ 50 kg/m2 . Methods: All records of bariatric surgery at a single centre were examined. Outcomes measured include Body Mass Index (BMI), percentage Excess Weight Loss (%EWL), Obstructive Sleep Apnoea (OSA), Hypertension (HTN) and Type 2 Diabetes Mellitus (T2DM). Statistical relationships between %EWL against age, type of surgery and gender were analysed. Results: 144 patients were found to meet the inclusion criteria. Mean pre-operative BMI was 56.9 ± 6.1 kg/m2 . 90 (62.5%) patients underwent sleeve gastrectomy, 24 (16.7%) had one anastomosis gastric bypass, 16 (11.1%) had biliopancreatic diversion (Scopinaro’s procedure), and 14 (9.7%) had sleeve gastrectomy with transit loop bipartition. 12 months post-operatively, mean BMI was 37.7 ± 7.5 kg/m2 , with a mean %EWL of 62.9% ± 17.9%. There was 100% OSA resolution, 95.3% HTN resolution, and 79.4% T2DM resolution. %EWL was found to decrease slightly with increased age, however no difference in %EWL was found between types of surgery or genders. Conclusion: Bariatric surgery is effective and may be justified in patients with super morbid obesity, including the elderly population. However, there is a great need for larger, longitudinal studies. This would be made possible by hospitals employing more regular and systematic reporting of data, and encouragement of patients to follow up.


2018 ◽  
Vol 132 (5) ◽  
pp. 439-445 ◽  
Author(s):  
S Derin ◽  
I Altun ◽  
S Koseoglu ◽  
C Sahin ◽  
M Yilmaz ◽  
...  

AbstractObjectives:This study aimed to investigate the relationship of epicardial fat thickness with severity of obstructive sleep apnoea, and clinical and polysomnographic parameters, and to determine independent predictors for epicardial fat thickness.Methods:A total of 84 patients with a body mass index of less than 30 kg/m2 and suspected sleep-disordered breathing were included in the study. The correlations of epicardial fat thickness with polysomnographic and clinical data, and severity of obstructive sleep apnoea, were investigated.Results:Mean epicardial fat thickness was 3.75 ± 1.07 mm in the study group (n = 62) and 2.97 ± 0.62 mm in the control group (n = 22) (p < 0.001). There were significant positive correlations between epicardial fat thickness and: apnoea/hypopnoea index, oxygen desaturation index 3 and minimum oxygen saturation, as well as with age, body mass index, and neck and waist circumferences.Conclusion:Non-obese obstructive sleep apnoea patients have thicker epicardial fat compared to controls. Oxygen desaturation index 3 has a strong correlation with epicardial fat thickness and is an independent predictor of it.


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