Different Impacts of Neck Circumference and Visceral Obesity on the Severity of Obstructive Sleep Apnea Syndrome

Kawaguchi, Yuji; Fukumoto, Shinya; Inaba, Masaaki; Koyama, Hideki; Shoji, Tetsuo; Shoji, Shigeichi; Nishizawà, Yoshiki

doi:10.1038/oby.2010.170

Cited by 95 publications

(66 citation statements)

References 32 publications

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“…174 Neck circumference also provides risk assessment for obstructive sleep apnea and has been found to be associated with the severity of obstructive sleep apnea independent of obesity. 175 …”

Section: Neck Circumferencementioning

confidence: 99%

Assessing Adiposity

Cornier¹,

Després²,

Davis³

et al. 2011

Circulation

715

356

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T he prevalence of obesity in the United States and the world has risen to epidemic/pandemic proportions. This increase has occurred despite great efforts by healthcare providers and consumers alike to improve the health-related behaviors of the population and a tremendous push from the scientific community to better understand the pathophysiology of obesity. This epidemic is all the more concerning given the clear association between excess adiposity and adverse health consequences such as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). The risks associated with overweight/obesity are primarily related to the deposition of adipose tissue, which leads to excess adiposity or body fatness. Furthermore, weight loss, specifically loss of body fat, is associated with improvement in obesity-related comorbidities. Before weight loss interventions can be recommended, however, patients must be assessed for their adiposity-related risk. Unfortunately, healthcare providers and systems have not done a good job of assessing for excess adiposity even in its simplest form, such as measuring body mass index (BMI). It is for these reasons that we must emphasize the importance of assessing adiposity in clinical practices. Although it can be argued that the entire population should be targeted as an important public health issue with a goal of prevention of weight gain and obesity, there are currently so many "at risk" individuals that simple strategies to identify and treat those individuals are necessary. We must identify those individuals at highest risk of comorbidities in order to identify those who might benefit the most from aggressive weight management.This scientific statement will first briefly review the epidemiology of obesity and its related comorbidities, supporting the need for improved assessment of adiposity in daily clinical practice. This will be followed by a discussion of some of the challenges and issues associated with assessing adiposity and then by a review of the methods available for assessing adiposity in adults. Finally, practical recommendations for the clinician in practice will be given with a goal of identifying more at-risk overweight/obese individuals.

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Section: Neck Circumferencementioning

confidence: 99%

Assessing Adiposity

Cornier¹,

Després²,

Davis³

et al. 2011

Circulation

715

356

View full text Add to dashboard Cite

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“…15 Further, the NHR has been used in adults to predict severity of OSA. 9,16,17 Our study aimed to answer three questions:…”

Section: Brief Summarymentioning

confidence: 99%

Neck Circumference-Height Ratio as a Predictor of Sleep Related Breathing Disorder in Children and Adults

Moul

Krishna

2016

Journal of Clinical Sleep Medicine

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Study Objectives: While neck circumference (NC) is a useful predictor of obstructive sleep apnea (OSA) in adults, childhood OSA is difficult to predict clinically. We utilized the neck circumference-height ratio (NHR) to normalize NC in growing children. Our study aimed to determine if (1) NC is a reproducible clinical measurement; (2) NHR predicts OSA in children; (3) this metric translates to adults. Methods: For this retrospective study, paired NC measurements (from clinic and sleep laboratory) in 100 consecutive adult subjects were used to confirm inter-observer reproducibility. Polysomnographic (PSG) and anthropometric data from children aged 5-18 years presenting consecutively between July 2007 and February 2012 was obtained. Children with genetic syndromes, severe neurological disorders, craniofacial abnormalities, tracheostomy, past adenotonsillectomy, in-hospital PSG or sleep efficiency < 80% were excluded. Data were analyzed using χ 2 test and logistic and linear regression models. These analyses were also applied to 99 adult patients with similar exclusion criteria. Results: Adult NC measurement had inter-observer correlation of 0.85 (N = 100). Among children, after correcting for BMI-Z scores, NHR conferred additional predictive value, in both logistic regression and linear models, for both apnea-hypopnea index (AHI) > 2 and > 5 (N = 507). In children, for NHR > 0.25, the odds ratio of AHI > 2 was 3.47. In adults, for NHR > 0.25, the odds ratio of AHI > 5 was 18. Conclusions: NHR can be included as a simple screening tool for OSA in children and adults, which along with other predictors, may improve the ability of clinicians to triage children and adults at risk for OSA for further evaluation with PSG. Keywords: obstructive sleep apnea, neck circumference, children Citation: Ho AW, Moul DE, Krishna J. Neck circumference-height ratio as a predictor of sleep related breathing disorder in children and adults.

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“…Clinically BMI and NC have been known to be strong predictors of OSA [15,18,22,26]. In this study, patients with OSA had greater BMI than control group.…”

Section: Discussionmentioning

confidence: 51%