Obstrüktif Uyku Apne Sendromu Antropometrik Ölçümler ve Vücut Bileşimi ile İlişkili midir?

Amaç: Genetik ve çevresel etmenler, yetersiz ve dengesiz beslenme, fiziksel aktivitedeki yetersizlik obeziteye neden olup vücut bileşimini etkilemektedir. Bu nedenle obezitenin, tip 2 diyabet, hipertansiyon (HT), bazı kanser türleri, kardiyovasküler hastalıklar (KVH), obstrüktif uyku apne sendromu (OSAS) ile ilişkili olabileceği bildirilmiştir. Bu çalışmada farklı düzeyde OSAS sınıflamasına sahip bireylerde vücut bileşimi ve bazı antropometrik ölçüm değerlerinin incelenmesi amaçlanmıştır. Bireyler ve Yöntem: Bu araştırma, Gazi Üniversitesi Tıp Fakültesi Hastanesi Uyku Bozuklukları Merkezinde, yaşları 19-64 yıl arasında değişen, obstrüktif uyku apne sendromu (OSAS) tanısı almış, 105 hasta (74 erkek, 31 kadın) üzerinde gerçekleştirilmiştir. Bireylerin vücut ağırlığı, boy uzunluğu, bel ve kalça çevresi, boyun çevresi ölçümleri alınmış ve vücut bileşimi analizi yapılmıştır. Bulgular: Bu çalışmada, Beden Kütle İndeksi (BKİ) >=30 kg/m2 olan bireylerin oranı %60.0'dır. Hafif, orta ve ağır OSAS'lı olan bireylerde obezite oranı sırasıyla %48.4, %56.7 ve %70.5 olarak saptanmıştır. Ağır OSAS'lı erkek bireylerin ortalama BKİ ve boyun çevresi değeri orta OSAS'lı erkek bireylere göre daha yüksek bulunmuştur (p

Is Obstructive Sleep Apnea Syndrome Severity Related with Anthropometric Measurements and Body Composition?

Aim: Genetic and environmental factors, inadequate and unbalanced nutrition, lack of physical activity cause obesity and affect on body composition. Therefore, it is reported that obesity may be associated with Type 2 diabetes, hypertension, some types of cancer, cardiovascular diseases, obstructive sleep apnea syndrome (OSAS). In this study, it was aimed to examine the body composition and some anthropometric measurements of individuals who have different OSAS classification. Subjects and Methods: This research was carried out on 105 patients (74 males, 31 females), diagnosed with obstructive sleep apnea syndrome (OSAS), aged 19-64 years, in Sleep Disorders Center of Gazi University Faculty of Medicine. The measurements of body weight, height, waist and hip circumference, neck circumference were taken and body composition analyses were obtained. Results: In this study, the ratio of individuals whose BMI >=30 kg/m2 was 60.0%. The percentage of obesity was found to be 48.4%, 56.7% and 70.5% in patients with mild, moderate and severe OSAS, respectively. The mean body mass index (BMI) and neck circumference (cm) values with severe OSAS were found higher than moderate OSAS in male (p<0.05). In women, the mean waist circumferences, BMI and body fat percentages were found higher in severe OSAS than mild OSAS (p<0.05). Apnea hypopnea index (AHI) was correlated with fat mass (kg) in males (r=0.327) and BMI in females (r=0.505) more than the other anthropometric measurements. Oxygen saturation (SaO2) was found higher correlated with body fat percentage in males (r=0.472) and fat mass in females (r=0.717) than the other anthropometric measurements. Conclusion: It was concluded that body composition parameters were related to OSAS. The percentage of obesity was found to be higher in individuals with OSAS. The correlation between body composition and some anthropometric measurements were different according to gender and OSAS severity.

___

  • 1. Yim-Yeh S, Rahangdale S, Nguyen ATD, Stevenson KE, Novack V, Veves A, et al. Vascular dysfunction in obstructive sleep apnea and type 2 diabetes mellitus. Obesity 2011;19(1):17-22.
  • 2. Kyzer S, Charuzi I. Obstructive sleep apnea in the obese. World J Surg 1998;22(9):998-1001.
  • 3. McArdle N, Hillman D, Beilin L, Watts G. Metabolic risk factors for vascular disease in obstructive sleep apnea: a matched controlled study. Am J Respir Crit Care Med 2007;175(2):190-5.
  • 4. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Longterm cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 2005;365(9464):1046-1053.
  • 5. Doherty LS, Kiely JL, Swan V, McNicholas WT. Long-term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome. Chest 2005;127(6):2076-2084.
  • 6. Schwab RJ, Gupta KB, Gefter WB, Metzger LJ, Hoffman EA, Pack AI. Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med 1995;152(5):1673-1689.
  • 7. Schwartz AR, Gold AR, Schubert N, Stryzak A, Wise RA, Permutt S, et al. Effect of weight loss on upper airway collapsibility in obstructive sleep apnea. Am Rev Respir Dis 1991;144(3 Pt 1):494-498.
  • 8. Demir AU. Obstrüktif uyku apne sendromu (OUAS) ve obezite. Hacettepe Tıp Dergisi 2007;38:177-193.
  • 9. Tuomilehto HP, Seppa JM, Partinen MM, Peltonen M, Gylling H, Tuomilehto JO, et al. Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am J Respir Criti Care Med 2009;179(4):320-327.
  • 10. Barnes M, Goldsworthy UR, Cary BA, Hill CJ. A diet and exercise program to improve clinical outcomes in patients with obstructive sleep apnea-a feasibility study. J Clin Sleep Med 2009;5(5):409-15.
  • 11. Köktürk O. Uykunun İzlenmesi.Polisomnografi. Tüberk Toraks 1999;47(4):499-511.
  • 12. World Health Organization (WHO). BMI classification. Available at: http://apps.who.int/bmi/index. jsp?introPage=intro_3.html&.Accessed June 8, 2014.
  • 13. Pekcan G. Beslenme durumunun saptanması. In: Baysal A (ed). Diyet El Kitabı. Ankara: Hatipoğlu Yayınevi, 2008:64-141.
  • 14. World Health Organization (WHO). Waist circumference and waist-hip ratio, 2011. Available at: http://whqlibdoc. who. int/publications/2011/9789241501491_eng. pdf. Accessed December 25, 2012.
  • 15. Köktürk O. Obstrüktif uyku apne sendromu epidemiyolojisi. Tüberk Toraks 1998;46(2):193-201.
  • 16. Hayran M, Hayran M. Sağlık Araştırmaları için Temel İstatistik. 1. Baskı. Ankara,Art Ofset Matbaacılık; 2011.
  • 17. Alberti K, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome a joint interim statement of the International Diabetes Federation task force on epidemiology and prevention; national heart, lung, and blood institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the study of obesity. Circulation 2009;120(16):1640-1645.
  • 18. Vgontzas AN, Tan TL, Bixler EO, Martin LF, Shubert D, Kales A. Sleep apnea and sleep disruption in obese patients. Arch Intern Med 1994;154(15):1705-1711.
  • 19. Göçmen H, Karadağ M. Obstrüktif uyku apnesi sendromu epidemiyolojisi. Türkiye Klinikleri J Surg Med Sci 2007;3(23):7-10.
  • 20. Berger G, Berger R, Oksenberg A. Progression of snoring and obstructive sleep apnoea: the role of increasing weight and time. Eur Respir J 2009;33(2):338-345.
  • 21. Güven SF, Çiftçi TU, Çiftçi B, Şipit T. Obstrüktif uyku apne sendromunda risk faktörleri. Toraks Derneği 5 Yıllık Kongresi Özet Kitabı 2002; PS-6142002.
  • 22. Ayık SÖ, Akhan G, Peker Ş. Obstruktif uyku apne sendromlu (OSAS) olgularda obezite sıklığı ve ek hastalıklar. Türk Toraks Dergisi 2011;12:105-110.
  • 23. Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ, et al. Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med 2002;162(8):893- 900.
  • 24. Redline S, Strohl KP. Recognition and consequences of obstructive sleep apnea hypopnea syndrome. Clin Chest Med 1998;19(1):1-19.
  • 25. Pillar G, Shehadeh N. Abdominal fat and sleep apnea the chicken or the egg? Diabetes Care 2008;31(Suppl 2):S303-309.
  • 26. Anandam A, Akinnusi M, Kufel T, Porhomayon J, El-Solh AA. Effects of dietary weight loss on obstructive sleep apnea: a meta-analysis. Sleep Breath 2013;17(1):227-234.
  • 27. Öğretmenoğlu O, Süslü AE, Yücel ÖT, Önerci TM, Şahin A. Body fat composition: a predictive factor for obstructive sleep apnea. Laryngoscope 2005;115(8):1493-1498.
  • 28. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Eng J Med 1993;328(17):1230- 1235.
  • 29. Pinto JA, Godoy LBdM, Marquis VWPB, Sonego TB, Leal CdFA, Artico MS. Anthropometric data as predictors of obstructive sleep apnea severity. Braz J Otorhinolaryngol 2011;77(4):516-521.
  • 30. Lovin S, Bercea R, Cojocaru C, Rusu G, Mihaescu T. Body composition in obstructive sleep apneahypopnea syndrome bio-impedance reflects the severity of sleep apnea. Multidiscip Respir Med 2010;5(1):44-9.
  • 31. Gabbay IE, Gabbay U, Lavie P. Obesity plays an independent worsening modifying effect on nocturnal hypoxia in obstructive sleep apnea. Sleep Med 2012;13(5):524-528.
  • 32. Major GC, Series F, Tremblay A. Does the energy expenditure status in obstructive sleep apnea favour a positive energy balance? Clin Invest Med 2007;30(6):E262-E8.
  • 33. Kezirian EJ, Kirisoglu CE, Riley RW, Chang E, Guilleminault C, Powell NB. Resting energy expenditure in adults with sleep disordered breathing. Arch Otolaryngol Head Neck Surg 2008;134(12):1270- 1275.
  • 34. Frankenfield D, Roth-Yousey L, Compher C. Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc 2005;105(5):775- 789.
  • 35. Peppard PE, Young T, Palta M, Dempsey J, Skatrud J. Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 2000;284(23):3015- 3021.
  • 36. Peppard PE, Ward NR, Morrell MJ. The impact of obesity on oxygen desaturation during sleepdisordered breathing. Am J of Respir Critic Care Med 2009;180(8):788-793.