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The Correlation Among Obesity, Apnea-Hypopnea Index, and Tonsil Size in Children^*

^* From the Department of Paediatrics, Kwong Wah Hospital, Hong Kong, SAR.

Correspondence to: Daniel K. Ng, FHKAM(Paed), Department of Paediatrics, 25 Waterloo Rd, Hong Kong SAR; e-mail: dkkng{at}ha.org.hk

Abstract

Background: The correlation between obesity and severity of obstructive sleep apnea (OSA) is well established in adults, but data are inconsistent in children. We hypothesized that there is a significant correlation between the degree of obesity and the severity of OSA in children.

Methods: We retrospectively reviewed records of weight, height, history, and polysomnography of all 1- to 15- year-old children referred to our sleep laboratory. Children with known anomalies and repeated polysomnography were excluded from this study. Obesity was defined as body mass index z score (BMI Z score) > 1.96. The correlation between BMI Z score and apnea-hypopnea index (AHI) was assessed. Possible confounding factors, ie, age, gender, and tonsil size, were adjusted by multiple linear regression.

Results: Four hundred eighty-two children were included in this study. Obese children had a significantly higher AHI (median, 1.5; interquartile range [IQR], 0.2 to 7.0) than the AHI of nonobese children (median, 0.7; IQR, 0.0 to 2.5). BMI Z score was significantly correlated with log-transformed AHI (Ln[AHI]) [r = 0.156, p = 0.003]. BMI Z score and tonsil size were still correlated with Ln(AHI) even after adjusted for other confounding factors (p = 0.001).

Conclusion: Degree of obesity as measured by BMI Z score and tonsil size are significantly related to severity of OSA as reflected by the AHI, although the correlation is mild.

Key Words: child • obesity • obstructive • polysomnography • sleep apnea

This article has been cited by other articles:

				Z. Xu, A. Jiaqing, L. Yuchuan, and K. Shen A Case-Control Study of Obstructive Sleep Apnea-Hypopnea Syndrome in Obese and Nonobese Chinese Children Chest, March 1, 2008; 133(3): 684 - 689. [Abstract] [Full Text] [PDF]