Waist-hip ratio is an independent predictor of moderate-to-severe OSA in nonobese males: a cross-sectional study

Abstract

Background Adiposity is a well-established risk factor for obstructive sleep apnea (OSA), but whether a combination of preferable anthropometric measurements may improve the accuracy of detecting OSA is unknown. This study aimed to explore the accuracies of the waist-hip ratio (WHR) in conjunction with the body mass index (BMI) when identifying the severity of OSA. Design A total of 2012 participants in the China-Japan Friendship Hospital from January 2018 to December 2019 underwent anthropometric measurements and an overnight home sleep test (HST). The 244 subjects who met the criteria for obstructive sleep apnea (apnea–hypopnea index (AHI) ≥ 5 events/hour) were divided into four groups: Group A (55 patients with WHR ≥ 0.9 and BMI ≥ 28 kg/m2); Group B (12 patients with WHR < 0.9 and BMI ≥ 28 kg/m2); Group C (69 patients with WHR ≥ 0.9 and BMI < 28 kg/m2); and group D (108 patients with WHR < 0.9 and BMI < 28 kg/m2). Results The AHI, apnea index (AI), hypopnea index (HI), and oxygen desaturation index (ODI) were significantly different among the 4 groups (p < 0.05). The WHR was positively correlated with AHI (r = 0.22, p < 0.001), AI (r = 0.270, p = 0.004), and ODI (r = 0.286, p = 0.0022) and negatively correlated with lowest oxygen pulse saturation (LSpO2) (r = 0.246, p = 0.008) only in nonobese patients. Moreover, the WHR was found to be a screening marker for moderate-to-severe OSA in Group D (p < 0.05). When used to identify severe OSA in Group D, the WHR cut-off point of 0.873 yielded a sensitivity of 65% and specificity of 56% (p < 0.05). Conclusion In nonobese male OSA patients, WHR is a moderate screening marker for moderate-to-severe OSA and an independent risk factor for OSA severity.

Triglyceride-glucose index and obstructive sleep apnea: a systematic review and meta-analysis

“…Our analysis supports the role of the TyG index in diagnosing OSA and the diagnostic ability of this index is comparable to that of other anthropometric indices, such as waist-to-hip ratio, WC, and BMI [ 56 – 58 ], or other lipid indices like the visceral adiposity index (VAI), the lipid accumulation product (LAP), or atherogenic index of plasma (AIP) [ 59 ]. Notably, as a result of our analysis, the TyG index is significantly higher in patients with OSA with an SMD of 0.86 (95% CI: 0.58–1.13), confirming the relationship between components of metabolic syndrome (triglyceride and glucose) and OSA, which has also been suggested previously [ 60 , 61 ].…”

Composite lipid indices in patients with obstructive sleep apnea: a systematic review and meta-analysis

“…Despite the fact that AUCs were almost similar for all three indices reported, LAP had a slightly higher AUC. Several studies investigated the diagnostic ability of anthropometric indices (e.g., waist-to-hip ratio (WHR), WC, and BMI) before [ 37 – 39 ]. Wang et al [ 37 ] compared WC, hip circumference (HC), and WHR for the diagnosis of moderate-to-severe OSA and severe OSA.…”

“…Several studies investigated the diagnostic ability of anthropometric indices (e.g., waist-to-hip ratio (WHR), WC, and BMI) before [ 37 – 39 ]. Wang et al [ 37 ] compared WC, hip circumference (HC), and WHR for the diagnosis of moderate-to-severe OSA and severe OSA. All indices showed inadequate discrimination (AUC < 0.7) for OSA diagnosis.…”

Adult obesity diagnostic tool: A narrative review

“…[51] Some studies also suggest that WHR serves as a moderate screening marker for moderate to severe obstructive sleep apnea and is an independent risk factor for obstructive sleep apnea. [52]…”