RESUMEN
OBJECTIVE: To determine the best cutoff value and reference standard of obese indexes and to compare their diagnostic value in screening, predicting and diagnosing obstructive sleep apnea-hypopnea syndrome (OSAHS) in male adults by receiver operating characteristic curve (ROC). METHODS: A total of 1110 male adults were included and cross-sectional study was adopted. Four parameters including: body mass index (BMI), neck circumference (NC), waist circumference (WC) and waist-to-hip ratio (WHR) were studied. The correlativity between apnea-hypopnea index (AHI) and BMI, NC, WC and WHR were analyzed by pearson correlation test. ROC curve was used to assess the diagnostic value and determine their best cutoff value to predict OSAHS and reference standard to screen/diagnose it. Their conformity in predicting OSAHS was analyzed by area under curve (AUC). SPSS software version 13.0 was used for statistical analysis and P< or =0.05 was considered to indicate statistical significance. RESULTS: (1) All of the fourindexes (BMI, NC, WC and WHR) showed a significantly positive correlation with AHI in adult male patients, with their Pearson coefficients as 0.373, 0.276, 0.291 and 0.127, respectively, and their P value were all below 0.001; (2) The best cutoff value of BMI, NC and WC in predicting OSAHS were 26.5 kg/m2 , 39 cm, 95 cm, and their corresponding sensitivity rates were 54%, 57% and 64% while rates of specificity as 73%, 65% and 53%; (3) BMI was better than other two indexes in predicting OASHS in adult male patients; (4) The value of BMI, NC and WC in screening OSAHS among adult male patients with 90% sensitivity and 10% rate of missed diagnosis as 23 kg/m2, 35 cm, 85 cm; (5) The value of BMI, NC and WC in screening OSAHS in adult male patients with 90% specificity and 10% misdiagnosis rate as 29 kg/m2, 43 cm, 105 cm, respectively. CONCLUSION: BMI seemed better in predicting OSAHS in male adults than NC, WC and WHR. The best cutoff values to predict OSAHS of BMI, NC and WC were 26.5 kg/m2, 39 cm and 95 cm, respectively. Their reference standards to screen OSAHS were 23 kg/m2, 35 cm and 85 cm while 29 kg/m2, 43 cm and 105 cm to predict OSAHS.
