Body Roundness Index Outperforms Body Mass Index in Predicting Obstructive Sleep Apnea Severity Among Chinese Adults

Area of Science:

• Medical Science
• Clinical Research
• Diagnostic Tools

Background:

• Obesity is a significant risk factor for obstructive sleep apnea (OSA).
• Body Mass Index (BMI) may not fully represent OSA risk due to its inability to account for visceral fat distribution.
• The Body Roundness Index (BRI), a measure reflecting visceral adiposity, requires further validation for OSA screening.

Purpose of the Study:

• To develop and validate a BRI-based model for predicting severe obstructive sleep apnea (OSA).
• To compare the efficacy of BRI with BMI in identifying severe OSA risk.

Main Methods:

• Retrospective and prospective enrollment of patients undergoing polysomnography (PSG).
• Utilized Least Absolute Shrinkage and Selection (LASSO) regression to identify predictors of severe OSA (Apnea-Hypopnea Index [AHI] ≥ 30 events/h).
• Developed and validated a predictive model incorporating BRI and other relevant factors, with subgroup analyses by sex and age.

Main Results:

• A total of 7579 patients were analyzed, with 51% diagnosed with severe OSA.
• Increased BRI significantly correlated with a higher risk of severe OSA (OR 2.01, p < 0.001).
• The BRI-based model demonstrated superior predictive performance (higher AUC) compared to models without BRI, especially in women and individuals ≤ 50 years.

Conclusions:

• The Body Roundness Index (BRI) is a more potent predictor of severe OSA than Body Mass Index (BMI).
• Incorporating BRI into predictive models enhances screening efficacy for severe OSA in Chinese adults.
• BRI shows particular promise in improving OSA screening sensitivity among women and younger populations.