The Biology and Genetics of Obesity and Obstructive Sleep Apnea

Tung, Avery

doi:10.1016/j.atc.2005.02.008

Cited by 13 publications

(10 citation statements)

References 72 publications

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“…Large neck-to-waist ratio is consistent with the typical phenotype seen in adults, in whom obesity is a major predictor of OSA 10,31 and central distribution of adiposity confers greater OSA risk. 12,15,32 In adolescents, visceral adiposity is associated with OSA risk in some, 32 although not all studies, 33 and enlarged neck circumference has been associated with increased upper airway collapsibility.…”

Section: Discussionsupporting

confidence: 48%

“…9 As in adults, the underlying pathophysiology is likely related to increased fat deposition in the neck, which reduces upper airway size or increases pharyngeal resistance. 10 Central distribution of adiposity is a particularly potent risk factor for OSA in adults. 11,12 In adults, large neck circumference (NC) identifi es individuals at increased risk of OSA.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

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

Katz

Vaccani

Barrowman

et al. 2014

Journal of Clinical Sleep Medicine

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Objectives: Central adiposity and large neck circumference are associated with obstructive sleep apnea (OSA) in adults but have not been evaluated in children as predictors of OSA. Study objectives were to determine whether (1) anthropometric measures including neck-to-waist ratio are associated with OSA in older children; (2) body fat distribution, measured by neck-to-waist ratio, is predictive of OSA in overweight/obese children. Methods: Cross-sectional study involving children 7-18 years scheduled to undergo polysomnography at a tertiary care children's hospital. OSA was defi ned as total apnea-hypopnea index > 5 events/h and/or obstructive apnea index > 1 event/h. Recursive partitioning was used to select candidate predictors of OSA from: age, sex, height and weight percentile, body mass index (BMI) z-score, neck-to-waist ratio, tonsil size, and Mallampati score. These were then evaluated using log binomial models and receiver operator characteristic analysis. Results: Two hundred twenty-two participants were included; 133 (60%) were overweight/obese, 121 (55%) male,47 (21%) had OSA. Neck-to-waist ratio (relative risk [RR] 1.97 per 0.1 units, 95% CI 1.48 to 2.84) and BMI z-score (RR 1.63 per unit, 95% CI 1.30 to 2.05) were identifi ed as independent predictors of OSA. Considering only overweight/obese children, neckto-waist ratio (RR 2.16 per 0.1 units, 95% CI 1.79 to 2.59) and BMI z-score (RR 2.02 per unit, 95% CI 1.25 to 3.26) also independently predicted OSA. However, in children not overweight/obese, these variables were not predictive of OSA. Conclusions: Neck-to-waist ratio, an index of body fat distribution, predicts OSA in older children and youth, especially in those who were overweight/obese.

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Section: Discussionsupporting

confidence: 48%

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

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

Katz

Vaccani

Barrowman

et al. 2014

Journal of Clinical Sleep Medicine

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“…1,[30][31][32][33] In adults, OSA is linked to obesity. [34][35][36][37][38] In a prospective evaluation of adults, NC corrected for height was actually a better predictor of OSA than symptoms or general obesity, as assessed by body mass index (BMI). This implies that the relationship between OSA and obesity is dependent on the variation in NC and suggests that central fat deposition in the neck and viscera is more contributory than generalized adiposity 38,39 to OSA development.…”

Section: Discussionmentioning

confidence: 99%

Inter‐ and intra‐rater reliability of neck circumference measurements in children

LaBerge

Vaccani

Gow

et al. 2008

Pediatric Pulmonology

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Summary. Rationale: Increased neck circumference is a risk factor for obstructive sleep apnea in adults. With rising obesity prevalence in children, it may be an important identifier of obstructive sleep apnea in children. The reliability of measuring neck circumference in children has not been systematically evaluated. Objective: To determine the inter-and intra-rater reliability of neck circumference measurements in children aged 2-16 years. Methods: Children aged 2-16 years with limb fractures were recruited. Neck circumference was measured by three investigators each using two separate unmarked paper tapes in the 2-5 year age group (N ¼ 43), and three separate tapes in the 6-10 and 11-16 year age groups (N ¼ 18 and 40). Results: Neck circumference measurements showed excellent inter-rater reliability for children 6-10 and 11-16 years (ICC ¼ 0.952 and 0.989). Substantial variation was observed for the 2-5 year age group (ICC ¼ 0.701). Good intra-rater reliability was demonstrated for the three groups (ICC range: 0.776, 0.950). Repeatability coefficients were 2.5-3.4 cm in the youngest age group and were 1.2-1.4 cm in the 6-16 year age group. Conclusion: In children 6-16 years old, neck circumference shows very good inter and good intra-rater reliability. Multiple measurements are not required for precision and reliability.

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“…OSA has long been known to have a familial occurrence, even after controlling for obesity, and there is emerging evidence that genetic factors help to influence the development of OSA (49). Large family studies have shown a much higher prevalence of OSA among offspring of family members with OSA when compared to the general population (49).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 98%