Application of body shape indicators in the evaluation of obstructive sleep apnea hypopnea syndrome in minors_West China Medical Journal

Authors：

QIAO Yixin ,  ZHAO Yu , WANG Jing , SHEN Tian , YU Rong

Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHAO Yu, Email: yutzhao@163.com

Keywords：

Obstructive sleep apnea hypopnea syndrome; Polysomnography; Body shape indicators

DOI：

10.7507/1002-0179.201909139

Video：

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Obstructive sleep apnea hypopnea syndrome (OSAHS) can affect the growth and development of minors. Although the gold standard for OSAHS diagnosis is an overnight polysomnography, its clinical application is limited due to the high requirements for equipment and environmental conditions. Body shape indicators can reflect the accumulation of fat in specific parts of the body. In recent years, body shape indicators (body mass index, neck circumference, waist circumference, waist to hip ratio, waist to height ratio, neck circumference to height ratio) have been increasingly used in the evaluation of minor OSAHS. This article will review the application of the above body shape indicators in the evaluation of minor OSAHS, aiming to provide a basis for better use of these indicators in the diagnosis and treatment of minor OSAHS.

Citation： QIAO Yixin, ZHAO Yu, WANG Jing, SHEN Tian, YU Rong. Application of body shape indicators in the evaluation of obstructive sleep apnea hypopnea syndrome in minors. West China Medical Journal, 2020, 35(9): 1149-1152. doi: 10.7507/1002-0179.201909139 Copy

1.	Kaditis AG, Alonso Alvarez ML, Boudewyns A, et al. Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management. Eur Respir J, 2016, 47(1): 69-94.
2.	Friberg D, Sundquist J, Li X, et al. Sibling risk of pediatric obstructive sleep apnea syndrome and adenotonsillar hypertrophy. Sleep, 2009, 32(8): 1077-1083.
3.	中華耳鼻咽喉頭頸外科雜志編委會, 中華醫學會耳鼻咽喉科學分會. 兒童阻塞性睡眠呼吸暫停低通氣綜合征診療指南草案(烏魯木齊). 中華耳鼻咽喉頭頸外科雜志, 2007, 42(2): 83-84.
4.	Buchanan A, Cohen R, Looney S, et al. Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls. Imaging Sci Dent, 2016, 46(1): 9-16.
5.	Maresky HS, Klar MM, Tepper J, et al. Mandibular width as a novel anthropometric measure for assessing obstructive sleep apnea risk. Medicine (Baltimore), 2019, 98(4): e14040.
6.	Raman VT, Splaingard M, Tumin D, et al. Utility of screening questionnaire, obesity, neck circumference, and sleep polysomnography to predict sleep-disordered breathing in children and adolescents. Paediatr Anaesth, 2016, 26(6): 655-664.
7.	Ishman S, Heubi C, Jenkins T, et al. OSA screening with the pediatric sleep questionnaire for adolescents undergoing bariatric surgery in teen-LABS. Obesity (Silver Spring), 2016, 24(11): 2392-2398.
8.	Leach J, Olson J, Hermann J, et al. Polysomnographic and clinical findings in children with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg, 1992, 118(7): 741-744.
9.	Mitchell RB, Kelly J. Outcome of adenotonsillectomy for obstructive sleep apnea in obese and normal-weight children. Otolaryngol Head Neck Surg, 2007, 137(1): 43-48.
10.	Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc, 2008, 5(2): 242-252.
11.	Kang KT, Lee PL, Weng WC, et al. Body weight status and obstructive sleep apnea in children. Int J Obes (Lond), 2012, 36(7): 920-924.
12.	Alonso-álvarez ML, Cordero-Guevara JA, Terán-Santos J, et al. Obstructive sleep apnea in obese community-dwelling children: the NANOS study. Sleep, 2014, 37(5): 943-949.
13.	Andersen IG, Holm JC, Hom?e P. Obstructive sleep apnea in children and adolescents with and without obesity. Eur Arch Otorhinolaryngol, 2019, 276(3): 871-878.
14.	Perfect MM, Archbold K, Goodwin JL, et al. Risk of behavioral and adaptive functioning difficulties in youth with previous and current sleep disordered breathing. Sleep, 2013, 36(4): 517-525B.
15.	Nafiu OO, Burke C, Lee J, et al. Neck circumference as a screening measure for identifying children with high body mass index. Pediatrics, 2010, 126(2): e306-e310.
16.	Lim YH, Choi J, Kim KR, et al. Sex-specific characteristics of anthropometry in patients with obstructive sleep apnea: neck circumference and waist-hip ratio. Ann Otol Rhinol Laryngol, 2014, 123(7): 517-523.
17.	Katz S, Murto K, Barrowman N, et al. Neck circumference percentile: a screening tool for pediatric obstructive sleep apnea. Pediatr Pulmonol, 2015, 50(2): 196-201.
18.	Au CT, Chan KCC, Liu KH, et al. Potential anatomic markers of obstructive sleep apnea in prepubertal children. J Clin Sleep Med, 2018, 14(12): 1979-1986.
19.	Qu XX, Esangbedo IC, Zhang XJ, et al. Obstructive sleep apnea syndrome is associated with metabolic syndrome among adolescents and youth in Beijing: data from Beijing child and adolescent metabolic syndrome study. Chin Med J (Engl), 2015, 128(17): 2278-2283.
20.	Chuang HH, Hsu JF, Chuang LP, et al. Differences in anthropometric and clinical features among preschoolers, school-age children, and adolescents with obstructive sleep apnea—a hospital-based study in Taiwan. Int J Environ Res Public Health, 2020, 17(13): 4663.
21.	Seidell JC. Waist circumference and waist/hip ratio in relation to all-cause mortality, cancer and sleep apnea. Eur J Clin Nutr, 2010, 64(1): 35-41.
22.	Bitsori M, Linardakis M, Tabakaki M, et al. Waist circumference as a screening tool for the identification of adolescents with the metabolic syndrome phenotype. Int J Pediatr Obes, 2009, 4(4): 325-331.
23.	Cespedes Feliciano EM, Rifas-Shiman SL, Quante M, et al. Chronotype, social jet lag, and cardiometabolic risk factors in early adolescence. JAMA Pediatr, 2019, 173(11): 1049-1057.
24.	Davidson TM, Patel MR. Waist circumference and sleep disordered breathing. Laryngoscope, 2008, 118(2): 339-347.
25.	Subramanian S, Jayaraman G, Majid H, et al. Influence of gender and anthropometric measures on severity of obstructive sleep apnea. Sleep Breath, 2012, 16(4): 1091-1095.
26.	Martinez-Rivera C, Abad J, Fiz JA, et al. Usefulness of truncal obesity indices as predictive factors for obstructive sleep apnea syndrome. Obesity (Silver Spring), 2008, 16(1): 113-118.
27.	de Sousa Caixêta JA, Saramago AM, de Cácia Pradella-Hallinan ML, et al. Waist-to-height ratio distinguish obstructive sleep apnea from primary snoring in obese children. Sleep Breath, 2015, 19(1): 231-237.
28.	Mokha JS, Srinivasan SR, Dasmahapatra P, et al. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: the Bogalusa Heart Study. BMC Pediatr, 2010, 10: 73.
29.	Savva SC, Tornaritis M, Savva ME, et al. Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obes Relat Metab Disord, 2000, 24(11): 1453-1458.
30.	Narang I, Al-Saleh S, Amin R, et al. Utility of neck, height, and tonsillar size to screen for obstructive sleep apnea among obese youth. Otolaryngol Head Neck Surg, 2018, 158(4): 745-751.
31.	Ho AW, Moul DE, Krishna J. Neck circumference-height ratio asa predictor of sleep related breathing disorder in children and adults. J Clin Sleep Med, 2016, 12(3): 311-317.

1. Kaditis AG, Alonso Alvarez ML, Boudewyns A, et al. Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management. Eur Respir J, 2016, 47(1): 69-94.
2. Friberg D, Sundquist J, Li X, et al. Sibling risk of pediatric obstructive sleep apnea syndrome and adenotonsillar hypertrophy. Sleep, 2009, 32(8): 1077-1083.
3. 中華耳鼻咽喉頭頸外科雜志編委會, 中華醫學會耳鼻咽喉科學分會. 兒童阻塞性睡眠呼吸暫停低通氣綜合征診療指南草案(烏魯木齊). 中華耳鼻咽喉頭頸外科雜志, 2007, 42(2): 83-84.
4. Buchanan A, Cohen R, Looney S, et al. Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls. Imaging Sci Dent, 2016, 46(1): 9-16.
5. Maresky HS, Klar MM, Tepper J, et al. Mandibular width as a novel anthropometric measure for assessing obstructive sleep apnea risk. Medicine (Baltimore), 2019, 98(4): e14040.
6. Raman VT, Splaingard M, Tumin D, et al. Utility of screening questionnaire, obesity, neck circumference, and sleep polysomnography to predict sleep-disordered breathing in children and adolescents. Paediatr Anaesth, 2016, 26(6): 655-664.
7. Ishman S, Heubi C, Jenkins T, et al. OSA screening with the pediatric sleep questionnaire for adolescents undergoing bariatric surgery in teen-LABS. Obesity (Silver Spring), 2016, 24(11): 2392-2398.
8. Leach J, Olson J, Hermann J, et al. Polysomnographic and clinical findings in children with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg, 1992, 118(7): 741-744.
9. Mitchell RB, Kelly J. Outcome of adenotonsillectomy for obstructive sleep apnea in obese and normal-weight children. Otolaryngol Head Neck Surg, 2007, 137(1): 43-48.
10. Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc, 2008, 5(2): 242-252.
11. Kang KT, Lee PL, Weng WC, et al. Body weight status and obstructive sleep apnea in children. Int J Obes (Lond), 2012, 36(7): 920-924.
12. Alonso-álvarez ML, Cordero-Guevara JA, Terán-Santos J, et al. Obstructive sleep apnea in obese community-dwelling children: the NANOS study. Sleep, 2014, 37(5): 943-949.
13. Andersen IG, Holm JC, Hom?e P. Obstructive sleep apnea in children and adolescents with and without obesity. Eur Arch Otorhinolaryngol, 2019, 276(3): 871-878.
14. Perfect MM, Archbold K, Goodwin JL, et al. Risk of behavioral and adaptive functioning difficulties in youth with previous and current sleep disordered breathing. Sleep, 2013, 36(4): 517-525B.
15. Nafiu OO, Burke C, Lee J, et al. Neck circumference as a screening measure for identifying children with high body mass index. Pediatrics, 2010, 126(2): e306-e310.
16. Lim YH, Choi J, Kim KR, et al. Sex-specific characteristics of anthropometry in patients with obstructive sleep apnea: neck circumference and waist-hip ratio. Ann Otol Rhinol Laryngol, 2014, 123(7): 517-523.
17. Katz S, Murto K, Barrowman N, et al. Neck circumference percentile: a screening tool for pediatric obstructive sleep apnea. Pediatr Pulmonol, 2015, 50(2): 196-201.
18. Au CT, Chan KCC, Liu KH, et al. Potential anatomic markers of obstructive sleep apnea in prepubertal children. J Clin Sleep Med, 2018, 14(12): 1979-1986.
19. Qu XX, Esangbedo IC, Zhang XJ, et al. Obstructive sleep apnea syndrome is associated with metabolic syndrome among adolescents and youth in Beijing: data from Beijing child and adolescent metabolic syndrome study. Chin Med J (Engl), 2015, 128(17): 2278-2283.
20. Chuang HH, Hsu JF, Chuang LP, et al. Differences in anthropometric and clinical features among preschoolers, school-age children, and adolescents with obstructive sleep apnea—a hospital-based study in Taiwan. Int J Environ Res Public Health, 2020, 17(13): 4663.
21. Seidell JC. Waist circumference and waist/hip ratio in relation to all-cause mortality, cancer and sleep apnea. Eur J Clin Nutr, 2010, 64(1): 35-41.
22. Bitsori M, Linardakis M, Tabakaki M, et al. Waist circumference as a screening tool for the identification of adolescents with the metabolic syndrome phenotype. Int J Pediatr Obes, 2009, 4(4): 325-331.
23. Cespedes Feliciano EM, Rifas-Shiman SL, Quante M, et al. Chronotype, social jet lag, and cardiometabolic risk factors in early adolescence. JAMA Pediatr, 2019, 173(11): 1049-1057.
24. Davidson TM, Patel MR. Waist circumference and sleep disordered breathing. Laryngoscope, 2008, 118(2): 339-347.
25. Subramanian S, Jayaraman G, Majid H, et al. Influence of gender and anthropometric measures on severity of obstructive sleep apnea. Sleep Breath, 2012, 16(4): 1091-1095.
26. Martinez-Rivera C, Abad J, Fiz JA, et al. Usefulness of truncal obesity indices as predictive factors for obstructive sleep apnea syndrome. Obesity (Silver Spring), 2008, 16(1): 113-118.
27. de Sousa Caixêta JA, Saramago AM, de Cácia Pradella-Hallinan ML, et al. Waist-to-height ratio distinguish obstructive sleep apnea from primary snoring in obese children. Sleep Breath, 2015, 19(1): 231-237.
28. Mokha JS, Srinivasan SR, Dasmahapatra P, et al. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: the Bogalusa Heart Study. BMC Pediatr, 2010, 10: 73.
29. Savva SC, Tornaritis M, Savva ME, et al. Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obes Relat Metab Disord, 2000, 24(11): 1453-1458.
30. Narang I, Al-Saleh S, Amin R, et al. Utility of neck, height, and tonsillar size to screen for obstructive sleep apnea among obese youth. Otolaryngol Head Neck Surg, 2018, 158(4): 745-751.
31. Ho AW, Moul DE, Krishna J. Neck circumference-height ratio asa predictor of sleep related breathing disorder in children and adults. J Clin Sleep Med, 2016, 12(3): 311-317.

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