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Original Research: SLEEP MEDICINE |

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

Yuen-yu Lam, FHKAM(Paed); Eric Y.T. Chan, MRCPCH; Daniel K. Ng, FHKAM(Paed); Chung-hong Chan, BSc; Josephine M.Y. Cheung, RPSGT; Shuk-yu Leung; Pok-yu Chow, FHKAM(Paed); Ka-li Kwok, FHKAM(Paed)
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*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@ha.org.hk



Chest. 2006;130(6):1751-1756. doi:10.1378/chest.130.6.1751
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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.

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