Is OSA risk proportional to BMI or parentally mediated? A questionnaire-based study in a cohort of Egyptian children

Abstract Introduction There is an increased body of evidence that Obstructive Sleep apnea (OSA) in obese patients has familial tendencies. This familial predilection might be mediated through tendencies to atopy with subsequent nasal obstruction, tendencies to adenotonsillar enlargement by fat deposition, or through differential fatty deposits in the airway. The aim of this study was to study if paternal or maternal OSA might be predictive of OSA in offspring and to determine the relationship of OSA to Body Mass Index (BMI), gender, and waist circumference (WC). Methods 100 obese patients retrieved from a consortium of Egyptian Schools were screened and their parents using sleep apnea clinical score (SACS), their gender, BMI, and WC were noted. For the performance of Receiver Operating Characteristic study, obese children were divided according to their SACS into high risk (1) (SACS>75) and low risk (0) (SACS≤75). The sensitivity of each of BMI, WC, gender, paternal and maternal SACS as predictors of OSA high risk was determined. Results: Paternal OSA risk was the single significant predictor of OSA risk in obese children (Sensitivity: 89%, Specificity: 97%), WC was the second-best predictor (Sensitivity: 78%, Specificity: 89%), female offsprings were at higher risk to be involved, BMI was a weak predictor of OSA risk with a cut off>34. Finally, yet importantly, maternal OSA risk was unrelated to OSA risk in obese children. Conclusion This study confirms that genetic factors might play a much more important role than the degree of obesity in determining OSA risk in obese patients, these findings open the door to more in-depth studies to understand the genetic mechanisms involved in such a relationship.