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

Autor: Cepeda FX; Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.; Universidade Nove de Julho (UNINOVE), São Paulo, Brazil., Virmondes L; Universidade Nove de Julho (UNINOVE), São Paulo, Brazil., Rodrigues S; Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Dutra-Marques ACB; Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Toschi-Dias E; Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.; Universidade Ibirapuera, São Paulo, Brazil., Ferreira-Camargo FC; Universidade Nove de Julho (UNINOVE), São Paulo, Brazil., Hussid MF; Universidade Nove de Julho (UNINOVE), São Paulo, Brazil., Rondon MUP; School of Physical Education and Sports, University of São Paulo, São Paulo, Brazil., Alves MJNN; Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Trombetta IC; Universidade Nove de Julho (UNINOVE), São Paulo, Brazil.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2019 May 21; Vol. 14 (5), pp. e0217058. Date of Electronic Publication: 2019 May 21 (Print Publication: 2019).
DOI: 10.1371/journal.pone.0217058
Abstrakt: 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.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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