• Respirology · Nov 2014

    Obesity hypoventilation syndrome in Japan and independent determinants of arterial carbon dioxide levels.

    • Yuka Harada, Yuichi Chihara, Masanori Azuma, Kimihiko Murase, Yoshiro Toyama, Chikara Yoshimura, Toru Oga, Hiroshi Nakamura, Michiaki Mishima, Kazuo Chin, and Japan Respiratory Failure Group.
    • Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
    • Respirology. 2014 Nov 1; 19 (8): 1233-40.

    Background And ObjectiveObesity hypoventilation syndrome (OHS) prevalence was previously estimated at 9% in patients with obstructive sleep apnoea (OSA) in Japan. However, the definition of OSA in that study was based on an apnoea-hypopnoea index (AHI) of ≥ 20/h rather than ≥ 5/h. Therefore, the prevalence of OHS in OSA was not measured in the same way as for Western countries. Our study objectives were to investigate the characteristics of Japanese patients with OHS.MethodsNine hundred eighty-one consecutive patients investigated for suspected OSA were enrolled. At least 90% of them were from urban areas, including 162 with obese OSA (body mass index (BMI) ≥ 30 kg/m(2) and AHI ≥ 5/h).ResultsThe prevalence of OHS (BMI 36.7 ± 4.9 kg/m(2) ) in OSA and that in obese OSA were 2.3% and 12.3%, respectively. Multiple regression analysis revealed that independent of age and BMI, arterial oxygen pressure (contribution rate (R(2) ) = 7.7%), 4% oxygen desaturation index (R(2)  = 8.9%), carbon monoxide diffusing capacity/alveolar volume (R(2)  = 8.3%), haemoglobin concentration (R(2)  = 4.9%) and waist circumference (R(2)  = 4.9%) were independently associated with arterial carbon dioxide pressure. After 12.3 ± 4.6 months of CPAP treatment, more than 60% of OHS patients no longer had hypercapnia.ConclusionsThe prevalence of OHS in OSA in Japan was 2.3%. The mean BMI of patients with OHS in Japan was lower than that in Western countries (36.7 kg/m(2) vs 44.0 kg/m(2) ).© 2014 Asian Pacific Society of Respirology.

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