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


METHODS
Inter-ethnic comparison study.


METHODS
Two sleep disorder clinics in Australia and Hong Kong.


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


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


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.
Lee
Richard W W
RW
Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, NSW, Australia.
Vasudavan
Sivabalan
S
Hui
David S
DS
Prvan
Tania
T
Petocz
Peter
P
Darendeliler
M Ali
MA
Cistulli
Peter A
PA
D000328:Adult; D044466:Asian People; D001315:Australia; D015992:Body Mass Index; D002508:Cephalometry; D019465:Craniofacial Abnormalities / Q000150:complications / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000208:ethnology*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000208:ethnology* / Q000628:therapy; D044465:White People
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