Indicadores de la poligrafía respiratoria y su relación con los parámetros antropométricos en obesos evaluados para cirugía bariátrica / Indicators of Respiratory Polygraphy and their Relation with Anthropometric Parameters in Obesity Patients Evaluated for Bariatric Surgery

RESUMEN

Objetivo: Correlacionar indicadores antropométricos; índice de cintura-cadera (ICC) y diámetro sagital (DS) con IAH en candidatos a cirugía bariátrica (CB). Materiales y métodos: Se registraron el IMC, ICC y DS. Se evaluó IAH relevante (> 15 eventos/hora) mediante poligrafía respiratoria (PR) y se correlacionó con sexo, edad > de 50 años, escala de Berlín, HTA, DS ≥ 30 e ICC ≥ 1. Resultados: Fueron analizados 81 pacientes (mujeres 50/61.73%). Las medias fueron; edad 46.32, SD 11.53, IMC 45.98 SD 8.41 (rango 35-77 kg/m²) y Epworth (ESS) 8.87, SD 4.86. El 100% presentó alto riesgo por Berlín, ESS >10 33.86% e HTA 39.51%. Los indicadores poligráficos (medias) fueron; tiempo de registro 407 minutos (SD 110) e IAH 20.66 (SD 24.02). La prevalencia de IAH > 5/hora fue del 77.77%, IAH > 15/hora; 34.56% y el 21% obtuvo > 30/hora. La media del DS fue de 30.9 (SD 4.60) y del ICC de 0.97 (SD 0.09). Modelos de regresión para DS ≥ 30 cm (OR 1.97 y p = 0.239) + ICC ≥ 1 (OR 1.394 y p = 0.636) no alcanzaron significación cuando se adicionó sexo masculino (OR 5.29 y p = 0.003). En regresión logística las variables no alcanzaron significación; DS ≥ 30 cm OR de 1.25 (CI95% 0.33-4.66) p = 0.739, ICC ≥ 1; OR 0.93 (SD 0.19-4.62) p = 0.939 y muestran predictor exclusivamente al sexo masculino (OR 4.20. CI95% 1.21-14.5) p = 0.023. Conclusiones: La obesidad central según ICC ≥ 1 y DS ≥ 30 cm no tuvo correlación con IAH > 15/hora. Continúan siendo necesarios métodos objetivos (PR o polisomnografía) para evaluar la severidad del trastorno.

ABSTRACT

Objective: To assess correlation between anthropometric indexes; waist to hip ratio (WHI), sagital diameter (SD) and AHI obtained from home respiratory polygraphy (RP) in bariatric surgery candidates (BS). Methods: BMI, WHI and SD were recorded for BS candidates. Sleep apnea was defined as significant if AHI >15 events/hour. Variables included in the model were; sex, age greater than 50 years, Berlin questionnaire, history of hypertension (HBP), SD ≥ 30 and WHI ≥ 1. Results: Data from 81 patients were analyzed (50 women, 61.73%), age 46.32, SD 11.53, BMI 45.98 SD 8.41 (range 35-77 kg/m²) and ESS 8.87 (SD 4.86). 100% had high risk by Berlin questionnaire, 33.86% had ESS >10, and 39.51% HBP. Respiratory polygraphy data were recording time 407 minutes (SD 110) and AHI 20.66 (SD 24.02). Prevalence of AHI > 5/hour (pathological) was 77.77%; significant AHI (> 15/hour) 34.56%, and 21% had > 30/hour. The SD was 30.9 (SD 4.60) and WHI of 0.97 (SD 0.09). 48.15% had a WHI ≥ 1. Logistic regression showed DS ≥ 30 cm (OR 1.97, p = 0.239) + WHI ≥ 1 (OR 1.394, p = 0.636) and it did not reach significance when male sex is added. Both variables included in the model did not reach statistical significance; SD ≥ 30 cm OR of 1.25 (95% CI 0.33-4.66) p = 0.739, ICC ≥ 1, OR 0.93 (SD 0.19-4.62) p = 0.939. In the model, male sex was the only predictor (OR 4.20, CI 95% 1.21. -14.5) p = 0.023. Conclusions: Central obesity measured by WHI ≥ 1 and SD ≥ 30 cm had no significant correlation with AHI > 15/h. Objective methods (RP or polysomnography) are needed to assess the severity of the disorder before prescribing bariatric surgery.