engleski

Proposed cut-off points for optimal BMI, age and neck circumference value in the stop-bang: comparison of Greece, Turkey and Croatia

Objectives/Introduction A high performance of the STOP-Bang questionnaire as a screening tool in different populations and patients in sleep clinics has been reported. Considering anthropometric specificities of populations in different European geographic regions, it is relevant to assess the role of body mass index (BMI), age and neck circumference (NC) in different populations and assess its optimal value in the prediction of risk for OSA. Methods A study has been conducted in 3 European Sleep medicine centers - Sleep Medicine Centre, University of Split School of Medicine in Split, Croatia ; Aristotle University G Papanikolaou Hospital Exohi in Thessaloniki, Greece ; and Ege University Faculty of Medicine Department of Respiratory Medicine in Izmir, Turkey. A total of 9154 respondents were included in the study, of whom 2364 in Greece (assessed with polygraphy), 3638 in Turkey (assessed with full-night polysomnography) and 3152 in Croatia [assessed with either polysomnography (n=1043) or polygraphy (n=2109)]. Results Patients from Greece were older (57.1±13.2 years) and had higher BMI (33.4±7.1 kg/m 2 ) compared to patients in Croatia (54.0±13.8 years and 29.8±5.9 kg/m 2 , respectively) and Turkey (51.2±12 years and 32.6±6.8 kg/m 2 , respectively). ROC curve analysis revealed that among the STOP-Bang items, both BMI and age may differ in their optimal cut-off value based on the Youden index among three included European countries. Specifically, BMI as providing optimal predictability of OSA diagnosis was set at higher values in Greece (30.8 kg/m 2 ; p< ; 0.001) compared to Turkey and Croatia (29.8 kg/m 2 and 26.6 kg/m 2 ; p< ; 0.001 ; respectively). Optimal age cut-off point was highest in Turkey (54.5 years, p< ; 0.001) compared to Greece (47.2 years ; p< ; 0.001) and Croatia (45.5 years ; p< ; 0.001), whereas NC was found to be similar in all three European countries (Greece 40.5 cm p< ; 0.001 ; Turkey 40.8 cm p< ; 0.001 ; Croatia 40.8 cm p< ; 0.001) Conclusions Even though STOP-Bang is widely used instrument in the assessment of OSA risk, findings on its interpretability with regard to population differences have been scarce. Current findings suggest that cut-off points for STOP-Bang may be more useful if adjusted to specific populations.

OSA, sleep, STOP

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