Simple Four-Variable Screening Tool For Identification Of Patients With Obstructive Sleep Apnea-Hypopnea Syndrome In Middle-Aged Male Snorers From Guangxi Region

Objective To evaluate the correlation between four variables that including neck circumference,body mass index(BMI),blood pressure(BP),and Epworth sleepiness scale(ESS)and obstructive sleep apnea-hypopnea syndrome(OSAHS)and the value of four-variable screening tool among snorers in Guangxi region.Methods Consecutive patients from August 2012 to December 2014,including 1319 middle-aged patients with snoring from Guangxi.All subjects underwent polysomnography(PSG)and physical examination which including neck circumference,BMI,BPand ESS.The diffrence of the neck circumference,BMI,BP,ESS were compared between the OSAHS and non OSAHS groups;The correlation between apnea-hypopnea index(AHI)and neck circumference,BMI,BP,ESS were analyzed.The best Cutoff-point of the four variables was selected by Literature or guidelines and screening score was assigned according to the logistic regression coefficient.And then made the four parameter integral table for screening OSAHS.The best integral value obtained through the receiver operating characteristic(ROC)curve.Results A total of 1099 subjects met the research criteria.Diagnose OSAHS total 960 subjects,and non OSAHS 139 subjects.The average of neck circumference,BMI and ESS were(39.9±3.0)cm,(27.8±3.5)kg/m2 and(9.3±5.9)score respectively.There was a positive association between AHI and the neck circumference,BMI and ESS(r=0.401,0.491,0.302 respectively,all P<0.001).The BP including three period when saw the doctor,before going to bed and wake up after the PSG were significantly positive correlated with AHI,especially the BP after wake up,and the correlation of diastolic blood pressure with AHI is more significant.a comprehensive integral table including four parameters for screening middle-aged snorers’ OSAHS was established:BMI(kg/m2)<18.5(0 point),18.5～23.9(6 points),24.0～27.9(12 points),≥28(18 points);Neck circumference(cm)<38.5(0 point),≥38.5(5 points);ESS(分)<9(0 point),≥9(2 points);Random diastolic blood pressure(mmHg)<90(0 point),90～99.9(1 points),100～109.9(2 points),≥110(3 points).When the integral value ≥15,the sensitivity in the diagnosis of OSAHS was 80.5%,the specificity was 64.1%;and the positive predictive value was 94.4%.Conclusions In middle-aged snorers in Guangxi,neck circumference,BMI,BPand ESS correlated to OSAHS,and there was a positive association between AHI and the neck circumference,BMI,BP,ESS.Simple four-variable screening tool for identifying of OSA has highly value.