Identifying the risk of obstructive sleep apnea in metabolic syndrome patients: Diagnostic accuracy of the Berlin Questionnaire

Autor(es)

Cepeda, Felipe X. ^{[1, 2]} ; Virmondes, Leslie ^[1] ; Rodrigues, Sara ^[2] ; Dutra-Marques, Akothirene C. B. ^[2] ; Toschi-Dias, Edgar ^{[2, 3]} ; Ferreira-Camargo, Fernanda C. ^[1] ; Hussid, Maria Fernanda ^[1] ; Rondon, Maria Urbana P. B. ^[4] ; Alves, Maria Janieire N. N. ^[2] ; Trombetta, Ivani C. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Nove Julho UNINOVE, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, Hosp Clin, Heart Inst InCor, Sao Paulo - Brazil

^[3] Univ Ibirapuera, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Sch Phys Educ & Sports, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: PLoS One; v. 14, n. 5 MAY 21 2019.
• Citações Web of Science: 0

Resumo

Background Obstructive sleep apnea (OSA) is a risk factor frequently present in patients with metabolic syndrome (MetS). Additionally, moderate and severe OSA are highly prevalent in patients with cardiac disease, as they increase the riskfor cardiovascular events by 80%. The gold standard diagnostic method for OSA is overnight polysomnography (PSG), which remains unaffordable for the overall population. The aim of the present study was to evaluate whether the Berlin Questionnaire (BQ) is anuseful tool for assessing the risk of OSA in patients with MetS. Methods 97 patients, previously untreated and recently diagnosed with MetS (National Cholesterol Education Program, Adult Treatment Panel III, ATP-III) underwent a PSG. OSA was characterized by the apnea-hypopnea index (AHI). BQ was administered before PSG and we evaluated sensitivity, specificity, positive and negative predictive values, and accuracy. Results Of the 97 patients with MetS, 81 patients had OSA, with 47 (48.5%) presenting moderate and severe OSA. For all MetS with OSA (AHI >= 5 events/hour), the BQ showed good sensitivity (0.65, 95% CI 0.54 to 0.76) and fair specificity (0.38, 95% CI 0.15-0.65) with a positive predictive value of 0.84, a negative predictive value of 0.18 and an 84% accuracy. Similarly, for moderate-to-severe OSA (AHI >= 15 events/hour) we found good sensitivity (0.73, 95% CI 0.58-0.85) and fair specificity (0.40, 95% CI 0.27-0.55). Interestingly, for severe OSA (AHI. 30 events/hour), there was a very good sensitivity (0.91, 95% CI 0.72-0.99) and moderate specificity (0.42, 95% CI 0.31-0.54). Conclusion The BQ is a valid tool for screening the risk of OSA in MetS patients in general, and it is particularly useful in predicting severe OSA. (AU)

• Processo FAPESP: 15/03274-0 - Marcadores metabólicos/inflamatórios e balanço simpato-vagal em pacientes com síndrome metabólica e apneia obstrutiva do sono: efeito da dieta hipocalórica e treinamento físico
• Beneficiário: Felipe Xerez Cepêda Fonseca
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 16/16831-7 - Marcadores metabólicos/inflamatórios e balanço simpato-vagal em pacientes com síndrome metabólica e apneia obstrutiva do sono: efeito da dieta hipocalórica e treinamento físico
• Beneficiário: Felipe Xerez Cepêda Fonseca
• Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado
• Processo FAPESP: 11/17533-6 - Aspectos autonômicos, metabólicos e inflamatórios da associação da síndrome metabólica com a apnéia obstrutiva do sono: efeito da dieta hipocalórica e do treinamento físico
• Beneficiário: Ivani Credidio Trombetta
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 13/15323-0 - Rigidez arterial e resistência vascular periférica na síndrome metabólica : efeito da dieta hipocalórica associada ao treinamento físico
• Beneficiário: Sara Rodrigues
• Modalidade de apoio: Bolsas no Brasil - Mestrado
• Processo FAPESP: 13/07651-7 - Valor prognóstico do padrão oscilatório da atividade nervosa simpática muscular em pacientes com insuficiência cardíaca
• Beneficiário: Edgar Toschi Dias
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado