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This Article Full Text (PDF) All Versions of this Article: chest.07-1611v1 133/3/684    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Xu, Z. Articles by Shen, K. Search for Related Content PubMed PubMed Citation Articles by Xu, Z. Articles by Shen, K.

A case-control study of obstructive sleep apnea/hypopnea syndrome in obese and nonon-obese Chinese children

Zhifei Xu, MBBS, zhifeixu@msn.com, Respiratory Department, Beijing Children's Hospital, Capital University of Medical Sciences; An Jiaqing, DN, sushan5116an@hotmail.com, ENT Department, Beijing Children's Hospital, Capital University of Medical Sciences; Li Yuchuan, PhD, drliyuchuan@yahoo.com.cn, Endocrinology Department, Beijing Children's Hospital, Capital University of Medical Sciences; Kunling Shen, PhD, kunling_shen@hotmail.com, Respiratory Department, Beijing Children's Hospital, Capital University of Medical Sciences

kunling_shen{at}hotmail.com

Abstract

BackgroundObesity is a risk factor for obstructive sleep apnea/hypopnea syndrome (OSAHS) in adults. However, prevalence of OSAHS in children is not clear and relationship between obesity and OSAHS remains controversial.

MethodsObese children were recruited from the endocrinology, respiratory and ENT clinics. Weight, age and sex matched children were recruited as controls. Standard questionnaires were administered and a standardized physical examination was carried out. Lateral neck roentgengraphy, sleep polysomnography (PSG), full blood count and arterial blood gas analysis were also performed. Children with BMI Z scores >1.96 were considered obese. An adenoidal-nasopharygeal ratio (A/N) ratio >0.67 was considered adenoid hypertrophy(ATH). OSAHS was defined as an apnea/hypopnea index (AHI) >5 or obstructive apnea index (OAI)>1.

ResultsNinety-nine obese children and 99 controls were recruited. Obese patients had significantly higher AHI and OAI, and lower sleep efficiency and MinSaO₂ than controls. The prevalence of OSAHS was significantly higher in obese children with or without ATH groups than their non-obese counterparts. (Odds ratio: 1.9, 95% CI: 1.21 to 4.7 and 108, 95% CI: 6.2 to 191 respectively). Obesity, tonsillar hypertrophy and adenoid hypertrophy were independent risk factors for OSAHS (P <0.001, 0.042 and 0.004 respectively). There was a positive correlation between the degree of obesity and AHI (r=0.535, P<0.001), and an inverse correlation between obesity and MinSaO₂ (r=-0.507, P<0.001). End tidal CO₂ (ETCO₂), PaCO₂ and bicarbonate were within the normal range.

ConclusionsObesity is a risk factor for OSAHS and the degree of obesity is positively correlated with the severity of OSAHS.

Key Words: obstructive sleep apnea • children • polysomnography • obesity • body mass index (BMI)