Different Craniofacial Characteristics Predict Upper Airway Collapsibility in Japanese-Brazilian and White Men

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art_SCHORR_Different_Craniofacial_Characteristics_Predict_Upper_Airway_Collapsibility_in_2016.PDF (736.16 KB)
Citações na Scopus
53
Tipo de produção
article
Data de publicação
2016
Editora
AMER COLL CHEST PHYSICIANS
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
MORIYA, Henrique T.
MALHOTRA, Atul
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
CHEST, v.149, n.3, p.737-746, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BACKGROUND: OSA pathogenesis is complex and may vary according to ethnicity. The anatomic component predisposing to OSA is the result of the interaction between bony structure and upper airway soft tissues and can be assessed using passive critical closing pressure (Pcrit). We hypothesized that Japanese-Brazilians and whites present different predictors of upper airway collapsibility, suggesting different causal pathways to developing OSA in these two groups. METHODS: Male Japanese-Brazilians (n = 39) and whites (n = 39) matched for age and OSA severity were evaluated by full polysomnography, Pcrit, and upper airway and abdomen CT scans for determination of upper airway anatomy and abdominal fat, respectively. RESULTS: Pcrit was similar between the Japanese-Brazilians and the whites (-1.0 +/- 3.3 cm H2O vs -0.4 +/- 3.1 cm H2O, P = .325). The Japanese-Brazilians presented smaller upper airway bony dimensions (cranial base, maxillary, and mandibular lengths), whereas the whites presented larger upper airway soft tissue (tongue length and volume) and a greater imbalance between tongue and mandible (tongue/mandibular volume ratio). The cranial base angle was associated with Pcrit only among the Japanese-Brazilians (r = -0.535, P < .01). The tongue/mandibular volume ratio was associated with Pcrit only among the whites (r = 0.460, P < .01). Obesity-related variables (visceral fat, BMI, and neck and waist circumferences) showed a similar correlation with Pcrit in the Japanese-Brazilians and the whites. CONCLUSIONS: Japanese-Brazilians and whites present different predictors of upper airway collapsibility. Although craniofacial bony restriction influenced Pcrit only in the Japanese-Brazilians, an anatomic imbalance between tongue and mandible volume influenced Pcrit among the whites. These findings may have therapeutic implications regarding how to improve the anatomic predisposition to OSA across ethnicities.
Palavras-chave
computed tomography, Pcrit, ethnicity, OSA
URI
https://observatorio.fm.usp.br/handle/OPI/14060
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Coleções
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/09
Artigos e Materiais de Revistas Científicas - ODS/03