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Differences in Craniofacial Structures and Obesity in Caucasian and Chinese Patients with Obstructive Sleep Apnea
Authors:Richard W. W. Lee  Sivabalan Vasudavan  David S. Hui  Tania Prvan  Peter Petocz  M. Ali Darendeliler  Peter A. Cistulli
Affiliation:1.Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital; Woolcock Institute of Medical Research; and University of Sydney, NSW, Australia;2.Discipline of Orthodontics, Sydney Dental Hospital, University of Sydney, Australia;3.Division of Respiratory Medicine, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong;4.Department of Statistics, Macquarie University, NSW, Australia
Abstract:

Study Objectives:

To explore differences in craniofacial structures and obesity between Caucasian and Chinese patients with obstructive sleep apnea (OSA).

Design:

Inter-ethnic comparison study.

Setting:

Two sleep disorder clinics in Australia and Hong Kong.

Patients:

150 patients with OSA (74 Caucasian, 76 Chinese).

Interventions:

Anthropometry, cephalometry, and polysomnography were performed and compared. Subgroup analyses after matching for: (1) body mass index (BMI); (2) OSA severity.

Measurements and Results:

The mean age and BMI were similar between the ethnic groups. Chinese patients had more severe OSA (AHI 35.3 vs 25.2 events/h, P = 0.005). They also had more craniofacial bony restriction, including a shorter cranial base (63.6 ± 3.3 vs 77.5 ± 6.7 mm, P < 0.001), maxilla (50.7 ± 3.7 vs 58.8 ± 4.3 mm, P < 0.001) and mandible length (65.4 ± 4.2 vs 77.9 ± 9.4 mm, P < 0.001). These findings remained after correction for differences in body height. Similar results were shown in the BMI-matched analysis (n = 66). When matched for OSA severity (n = 52), Chinese patients had more craniofacial bony restriction, but Caucasian patients were more overweight (BMI 30.7 vs 28.4 kg/m2, P = 0.03) and had a larger neck circumference (40.8 vs 39.1 cm, P = 0.004); however, the ratios of BMI to the mandible or maxilla size were similar.

Conclusions:

Craniofacial factors and obesity contribute differentially to OSA in Caucasian and Chinese patients. For the same degree of OSA severity, Caucasians were more overweight, whereas Chinese exhibited more craniofacial bony restriction.

Citation:

Lee RWW; Vasudavan S; Hui DS; Prvan T; Petocz P; Darendeliler MA; Cistulli PA. Differences in craniofacial structures and obesity in Caucasian and Chinese patients with obstructive sleep apnea. SLEEP 2010;33(8):1075-1080.
Keywords:Obstructive sleep apnea   ethnicity   craniofacial   obesity
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