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Comparative Study
. 2014 Apr 15;10(4):397-402.
doi: 10.5664/jcsm.3614.

Comparison of BMI, AHI, and apolipoprotein E ε4 (APOE-ε4) alleles among sleep apnea patients with different skeletal classifications

Jason J Roedig  1 , Barbara A Phillips  2 , Lorri A Morford  1 , Joseph E Van Sickels  1 , Gabriel Falcao-Alencar  1 , David W Fardo  3 , James K Hartsfield Jr  4 , Xiuhua Ding  3 , G Thomas Kluemper  1
Affiliations
Comparative Study

Comparison of BMI, AHI, and apolipoprotein E ε4 (APOE-ε4) alleles among sleep apnea patients with different skeletal classifications

Jason J Roedig et al. J Clin Sleep Med. .

Abstract

Study objectives: This case-control study investigated whether variations within the APOE-ε gene were associated with having a convex facial profile (skeletal Class II) compared to exhibiting a straight or concave facial profile (Class I or Class III) among patients with obstructive sleep apnea (OSA). Associations between the apnea-hypopnea index (AHI) and body mass index (BMI) scores for these OSA patients were also examined in the context of facial profile.

Method: OSA patients with an AHI ≥ 15 were recruited from a sleep clinic and classified by facial and dental occlusal relationships based on a profile facial analysis, lateral photographs, and dental examination. Saliva was collected as a source of DNA. The APOE-ε1-4 allele-defining single nucleotide polymorphisms (SNPs) rs429358 and rs7412 were genotyped. A χ(2) analysis was used to assess Hardy-Weinberg equilibrium and for association analysis (significance at p < 0.05). ANOVA and Fisher exact test were also used.

Result: Seventy-six Caucasian OSA patients participated in the study-25 Class II cases and 51 non-Class II cases. There was no association of the APOE-ε4 allele with facial profile among these OSA patients. Class II OSA patients had significantly lower BMIs (30.7 ± 5.78) than Class I (37.3 ± 6.14) or Class III (37.8 ± 6.17) patients (p < 0.001), although there was no statistical difference in AHI for Class II patients compared with other groups.

Conclusion: OSA patients with Class II convex profile were more likely to have a lower BMI than those in other skeletal groups. In fact 20% of them were not obese, suggesting that a Class II convex profile may influence or be associated with OSA development independent of BMI.

Keywords: AHI; APOE-ε; BMI; Obstructive sleep apnea; facial profile; skeletal malocclusion.

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Figures

Figure 1
Figure 1. Average age, BMI and AHI grouped by facial category in OSA patients.
See this image and copyright information in PMC

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