Does Neck-to-Waist Ratio Predict Obstructive Sleep Apnea in Children?

Katz, Sherri L.; Vaccani, Jean‐Philippe; Barrowman, Nick; Momoli, Franco; Bradbury, Carol L; Murto, Kimmo

doi:10.5664/jcsm.4284

Cited by 32 publications

(32 citation statements)

References 37 publications

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“…Our study observed that obesity, defined as BMI above the 95 th percentile, was significantly related to OSAS in children. Meanwhile, Katz et al reported that neck to waist ratio, an index of body fat distribution, predicts OSA in older children and youth who are obese or overweight [33]. Similarly, we found neck circumference ≥ 30 cm, neck/height ratio ≥ 0.25 and waist/hip ratio ≥ 0.95 were associated with OSA.…”

Section: Discussionsupporting

confidence: 77%

Risk factors of obstructive sleep apnea syndrome in children

Xu¹,

Wu²,

Tai³

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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Background: The known risk factors of childhood OSAS include tonsillar and adenoidhypertrophy, obesity, craniofacial anomalies, neuromuscular disorders and African-American (AA) ancestry. Whether other factors such as allergic rhinitis (AR), premature, environmental tobacco smoking (ETS) are associated with OSAS are inconsistent in different studies. Our study enrolled children of a broad age range and included potential risk factors of OSAS derived from previous studies and our own experience. Our objective is to identify risk factors of OSAS in children in a clinical setting. Methods: Children between 2 and 15 years of age exhibiting snoring symptoms who visited the sleep center for polysomnography (PSG) were enrolled. All children completed a questionnaire, physical examination and PSG. The questionnaire included demographic data and information related to potential risk factors for sleep disorders. A physical examination included measurements of height, weight, neck circumference, waist and hip ratio, visual evaluation of the tonsils and the degree of adenoid obstruction. Children with obstructive apnea-hypopnea index (OAHI) ≥ 1 were defined as OSAS.Results: A total of 1578 children were enrolled and1009 children exhibited OSAS. Univariate analyses showed that snoring occurring for ≥ 3 months, male gender, preterm birth, breastfeeding, obesity, neck circumference ≥ 30 cm, waist/hip ratio ≥ 0.95, tonsillar hypertrophy, and adenoid hypertrophy were associated with OSAS. The proportion of low educational level was higher in parents who breastfed their babies than those who didn't. Multivariate analysis showed that snoring for ≥ 3 months, male gender, obesity, breastfeeding, tonsillar hypertrophy, and adenoid hypertrophy were associated with OSAS. Confounders such as socioeconomic status, parental occupation, and healthrelated behaviors should be explored further to investigate the relationship between breastfeeding and OSAS. Conclusion: The independent risk factors for OSAS in children included snoring ≥ 3 months, male gender, obesity, breastfeeding, tonsillar and adenoid hypertrophy. The study was registered on Clinical Trials government (NCT02447614). The name of the trial is "Follow-up Studies of Primary Snoring (PS) and Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) in Chinese Children" and the URL is https://clinicaltrials.gov/.

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Section: Discussionsupporting

confidence: 77%

Risk factors of obstructive sleep apnea syndrome in children

Xu¹,

Wu²,

Tai³

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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“…Katz et al reported on 222 children between the ages of 7 and 18 years who were referred to primary care physicians for SDB; 60% had overweight or obesity. They found the neck-to-waist ratio to be an independent predictor of OSA, except in children with a BMI greater than the 99th percentile (15). In our population, neither neck circumference nor waist circumference correlated with oAHI or oxygen saturation nadir; however, sagittal abdominal diameter was significantly correlated with both oAHI and the oxygen saturation nadir.…”

Section: Discussioncontrasting

confidence: 64%

OSA screening with the pediatric sleep questionnaire for adolescents undergoing bariatric surgery in teen‐LABS

Ishman

Heubi

Jenkins

et al. 2016

Obesity

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Objective Obstructive sleep apnea (OSA) is reported in 70% of adolescents who present for bariatric surgery. The Pediatric Sleep Questionnaire (PSQ) was developed to identify children at risk for OSA, but is not validated in adolescents with obesity. The aims of this study:1)to assess validity of the PSQ to detect OSA, and 2)determine the correlation between anthropometric and polysomnography measurements. Methods Cross-sectional assessment of Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) participants at high-risk for OSA. Participants completed an overnight polysomnography and caregivers completed the PSQ. Results Forty-five participants (84% female, 78% Caucasian, mean age=16.7±1.5 years) were evaluated. Mean BMI was 51.3±7.7kg/m2 and mean obstructive apnea-hypopnea index (oAHI) was 6.1±5.9 events/hour. For diagnosis of OSA (oAHI≥5), the total PSQ score sensitivity, specificity, and positive predictive value (PPV) were 86%, 38%, and 55%, respectively. For snoring >50% of the time, PPV was 84%, sensitivity was 64%, and specificity was 43%. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir (rho=0.34, P=0.027), whereas BMI, neck, and waist circumference correlated with neither. Conclusion The PSQ demonstrated low specificity and PPV and the question regarding snoring >50% of the time did not effectively identify OSA. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir.

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“…15 Katz et al had shown that neck to waist ratio, an index of body fat distribution predicts obstructive sleep apnoea in overweight/obese children. 16 Another study conducted in 324 Greek children aged 9 -13 years found that NC was associated with most cardiovascular disease (CVD) risk factors. The study showed that the association of NC and CVD was comparable to the observed co-relations of BMI, WC, hip circumference (HC), waist-to-hip ratio (WHR) and WHtR with CVD.…”

Section: Discussionmentioning

confidence: 99%

Neck circumference measurement as a screening tool for obesity in children

Yashoda

Swetha

Goutham

2017

Int J Contemp Pediatr

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Background: Childhood obesity is a rising epidemic and a major public health problem with the risk for type 2 diabetes mellitus, hypertension and cardiovascular disorders in later life. Neck circumference (NC), a marker of upper body subcutaneous adipose tissue distribution can predict higher metabolic risk. The aim of the present study was to evaluate the association between neck circumference (NC) and obesity.Methods: This cross-sectional prospective observational study was conducted in Bangalore in the month of October 2016. 172 male and 161 female students, aged 13-17 years were screened. Anthropometric markers of obesity measured included body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and compared with neck circumference (NC) of the same subjects. Pearson’s correlation coefficient was calculated between neck circumference and other obesity indices, and receiver operating characteristic curve analysis was used to determine the best cutoff value of neck circumference in predicting high BMI. Results: Overall, 13.2% boys and 9.9% girls were found overweight/obese. The mean BMI was 25.27±2.09kg/m2 and25.17±2.23kg/m2, mean neck circumference was 33.43±2.3cm and 31.50±1.4 in overweight/obese boys and girl respectively. All of the anthropometric parameters were found to be significantly higher in overweight/obese children than with their normal weight peers and higher in boys compared to girls. The neck circumference in boys was significantly greater than girls and higher in overweight/obese with P<0.001. The best cut-off value of neck circumference by ROC to identify boys with a high BMI was 32cm with sensitivity of (81.82%), specificity (89.06%), and for girls was 30cm with sensitivity of (84.85%), specificity (87.5%). Neck circumference had a strong positive correlation with other anthropometric measures BMI, WC, waist hip ratio in both boys and girls (p <0.001).Conclusions: Neck circumference significantly correlated with other indices of obesity. It can be used with great reliability to screen overweight and obesity in children. NC can be considered as a simple, time saving and inexpensive clinical tool for detection of obesity in large population-based studies in children and adolescents.

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Does Neck-to-Waist Ratio Predict Obstructive Sleep Apnea in Children?

Cited by 32 publications

References 37 publications

Risk factors of obstructive sleep apnea syndrome in children

Risk factors of obstructive sleep apnea syndrome in children

OSA screening with the pediatric sleep questionnaire for adolescents undergoing bariatric surgery in teen‐LABS

Neck circumference measurement as a screening tool for obesity in children

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