Download PDF
CC BY-NC-ND 4.0 · Sleep Sci 2023; 16(03): e323-e328
DOI: 10.1055/s-0043-1772827
Short Communication

The Cervical Fat Tissue Volume is a Predictor for Moderate to Severe OSA

Glenda Ernst 
1   Hospital Británico, Neumonología, CABA, Buenos Aires, Argentina
,
Pablo Dalzotto
2   Hospital Británico, Diagnóstico por Imágenes, CABA, Buenos Aires, Argentina
,
Melina Saban
1   Hospital Británico, Neumonología, CABA, Buenos Aires, Argentina
,
Fernando M. Ferraro
2   Hospital Británico, Diagnóstico por Imágenes, CABA, Buenos Aires, Argentina
,
Alejandro Salvado
1   Hospital Británico, Neumonología, CABA, Buenos Aires, Argentina
,
Eduardo Enrique Borsini
1   Hospital Británico, Neumonología, CABA, Buenos Aires, Argentina
› Author Affiliations Funding No funding was received for this research.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objective Obstructive sleep apnea (OSA) is a disorder characterized by recurrent pharyngeal obstruction during sleep, in which upper airway anatomy plays a key role in its pathogenesis. The aim of this study was to describe whether the quantification of cervical fat tissue volume (CFTV) obtained by Computed Tomography (CT)cephalometry is related to the severity of OSA.

Methods Retrospective study between 2018 and 2020 in those patients > 18 years old, with diagnosis of OSA who performed a volumetric cephalometric imaging. Three-dimensional reconstruction of the images was performed and CFTV was measured.

Results 91 patients were included in this study of which: without OSA (n: 7), mild (n: 19), moderate (n: 39) and severe OSA (n: 26). We observed a progressive increase of CFTV related to OSA severity has been observed (without OSA: 58.9 ml (47.9-87.5), mild: 59.1ml (48.4-78.3), moderate: 71 ml (42.6-127.1) and severe OSA 103.6 ml (81-153); p < 0.01); nevertheless, no differences were found in the airway volume and neck area. It was showed a significant correlation between CFTV and OSA indicators: AHI, ODI and T90 (Sp r: 0.48; 0.38 and 0.36; p < 0.01 respectively). CFTV cut-off value to discriminate AHI >15 ev/h with best sensitivity-specificity relationship was 64.1 ml with an area under the curve of 0.6 ± 0.06. Multivariate analysis showed that CFTV is a predictor for moderate to severe OSA (OR:3.05, IC95%: 1.14-8.17).

Conclusion Cervical fat quantification by CT cephalometry correlates with OSA severity in adults. Fat volume > 64.1 ml increased more than three times the risk of OSA moderate to severe.

Keyword

sleep apnea obstructive - adiposity - cephalometry


Publication History

Received: 22 April 2022

Accepted: 27 November 2022

Article published online:
11 September 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Mediano O, González Mangado N, Montserrat JM. et al; el Spanish Sleep Network. International Consensus Document on Obstructive Sleep Apnea. Arch Bronconeumol 2022; 58 (01) 52-68
    CrossrefPubMedGoogle Scholar
  • 2 Seeger-Zybok RK, Klingelhöfer D, Groneberg DA. Global Risk Factor Evaluation of Obstructive Sleep Apnea in Relation to Research Activity and Socioeconomic Factors. Int J Environ Res Public Health 2020; 17 (18) 6785
    CrossrefPubMedGoogle Scholar
  • 3 Senaratna CV, Perret JL, Lodge CJ. et al. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev 2017; 34: 70-81
    CrossrefPubMedGoogle Scholar
  • 4 Tufik S, Santos-Silva R, Taddei JA, Bittencourt LR. Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med 2010; 11 (05) 441-446
    CrossrefPubMedGoogle Scholar
  • 5 Benjafield AV, Ayas NT, Eastwood PR. et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med 2019; 7 (08) 687-698
    CrossrefPubMedGoogle Scholar
  • 6 Malhotra A, White DP. Obstructive sleep apnoea. Lancet 2002; 360 (9328) 237-245
    CrossrefPubMedGoogle Scholar
  • 7 Davies RJ, Stradling JR. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome. Eur Respir J 1990; 3 (05) 509-514
    CrossrefPubMedGoogle Scholar
  • 8 Laxmi NV, Talla H, Meesala D, Soujanya S, Naomi N, Poosa M. Importance of cephalographs in diagnosis of patients with sleep apnea. Contemp Clin Dent 2015; 6 (Suppl. 01) S221-S226
    CrossrefPubMedGoogle Scholar
  • 9 Sakat MS, Sütbeyaz Y, Yüceler Z, Kantarci M, Kilic K, Kurt S. Cephalometric Measurements With Multislice Computed Tomography in Patients With Obstructive Sleep Apnea Syndrome. J Craniofac Surg 2016; 27 (01) 82-86
    CrossrefPubMedGoogle Scholar
  • 10 Ryu HH, Kim CH, Cheon SM. et al. The usefulness of cephalometric measurement as a diagnostic tool for obstructive sleep apnea syndrome: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119 (01) 20-31
    CrossrefPubMedGoogle Scholar
  • 11 Cizza G, de Jonge L, Piaggi P. et al; NIDDK Sleep Extension Study. Neck circumference is a predictor of metabolic syndrome and obstructive sleep apnea in short-sleeping obese men and women. Metab Syndr Relat Disord 2014; 12 (04) 231-241
    CrossrefPubMedGoogle Scholar
  • 12 Mihaicuta S, Udrescu L, Udrescu M. et al. Analyzing Neck Circumference as an Indicator of CPAP Treatment Response in Obstructive Sleep Apnea with Network Medicine. Diagnostics (Basel) 2021; 11 (01) 86
    CrossrefPubMedGoogle Scholar
  • 13 Isono S. Obesity and obstructive sleep apnoea: mechanisms for increased collapsibility of the passive pharyngeal airway. Respirology 2012; 17 (01) 32-42
    CrossrefPubMedGoogle Scholar
  • 14 Welch KC, Foster GD, Ritter CT. et al. A novel volumetric magnetic resonance imaging paradigm to study upper airway anatomy. Sleep 2002; 25 (05) 532-542
    CrossrefPubMedGoogle Scholar
  • 15 Kritikou I, Basta M, Tappouni R. et al. Sleep apnoea and visceral adiposity in middle-aged male and female subjects. Eur Respir J 2013; 41 (03) 601-609
    CrossrefPubMedGoogle Scholar
  • 16 Danisi JM, Fernandez-Mendoza J, Vgontzas AN. et al. Association of visceral adiposity and systemic inflammation with sleep disordered breathing in normal weight, never obese adolescents. Sleep Med 2020; 69: 103-108
    CrossrefPubMedGoogle Scholar
  • 17 Cielo CM, Keenan BT, Wiemken A, Tapia IE, Kelly A, Schwab RJ. Neck fat and obstructive sleep apnea in obese adolescents. Sleep 2021; 44 (11) zsab158
    CrossrefPubMedGoogle Scholar
  • 18 Zhang Z, Wang Y, Li H, Ni L, Liu X. Age-specific markers of adiposity in patients with obstructive sleep apnea. Sleep Med 2021; 83: 196-203
    CrossrefPubMedGoogle Scholar
  • 19 Liu Y, Zou J, Qian Y. et al. The association between obesity indices and obstructive sleep apnea is modified by age in a sex-specific manner. Sleep Breath 2021; 25 (01) 189-197
    CrossrefPubMedGoogle Scholar
  • 20 Pinto JA, Godoy LBM, Marquis VWPB, Sonego TB, Leal CFA, Ártico MS. Anthropometric data as predictors of Obstructive Sleep Apnea Severity. Rev Bras Otorrinolaringol (Engl Ed) 2011; 77 (04) 516-521
    Google Scholar
  • 21 Borges PdeT, Filho ES, Araujo TM. et al. Correlation of cephalometric and anthropometric measures with obstructive sleep apnea severity. Int Arch Otorhinolaryngol 2013; 17 (03) 321-328 DOI: 10.7162/S1809-977720130003000013.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Neelapu BC, Kharbanda OP, Sardana HK. et al. Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: A systematic review and meta-analysis of cephalometric studies. Sleep Med Rev 2017; 31: 79-90
    CrossrefPubMedGoogle Scholar
  • 23 Franco I, Reis R, Ferreira D. et al. The impact of neck and abdominal fat accumulation on the pathogenesis of obstructive sleep apnea. Rev Port Pneumol (2006) 2016; 22 (04) 240-242
    PubMedGoogle Scholar