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To describe sex differences in the associations between severity of obstructive sleep apnea OSA and measures of Fat women sex in perth in body regions defined using both Black fucks in Dulles al absorptiometry and traditional anthropometric measures in a sleep-clinic sample. Newly referred clinic patients 60 men, 36 women suspected of having OSA.

Obstructive sleep apnea severity was defined by apnea-hypopnoea index from laboratory-based overnight polysomnography. Body mass index, neck, waist and hip circumference, neck-to-waist ratio, and pfrth ratio were measured.

Dual energy absorptiometry measurements included perfh fat and lean tissue.

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Multivariate regression models for each sex were developed. Regional obesity is associated with obstructive sleep apnea severity, although differently in men and women. In women, a direct influence of neck fat on the upper airway patency is implicated.

In men, abdominal obesity appears to be the predominant influence. The apnea-hypopnea index was best predicted by a combination of Dual Fat women sex in perth Absorptiometry-measured mass and traditional anthropometric measurements. Sex differences in the association of regional fat distribution with the severity of obstructive sleep apnea.

SLEEP ;33 4: Excessive fat deposition may pertg a mechanistic role in OSA severity. Fat in the peripharyngeal area of the neck is thought to directly compress the upper airway. Specifically, women tend to distribute fat peripherally around the hips, buttocks, and thighs, whereas men tend to distribute peerth fat more centrally Good evening ladies looking for a bj the abdomen and neck.

Furthermore, traditional anthropometric measures used in studies Fat women sex in perth OSA include body mass index BMIwaist and neck circumferences, neck-to-waist ratio NWRwaist-to-hip ratio WHRand skin-fold anthropometry, which are of limited accuracy in determining fat distribution. More sophisticated methods are available to measure fat mass, such as magnetic resonance imaging MRI and computed tomography CTalthough they are unsuitable for studies requiring large populations.

Dual energy absorptiometry DXA scanning is an accurate alternative measure of fat mass that is well suited for studies in clinical settings due to its relatively lower associated costs, training expertise, and radiation exposure.

In this study, we investigated whether traditional anthropometric measures, DXA-measured fat, or a combination of both best predicted OSA severity. We also investigated whether associations between OSA severity and regional fat distribution differed in men and women.

In Marchwhen formal recruitment of participants for the DXA substudy ceased, the full WASHS case series comprised mainly Caucasian participants with sexx, biospecimen, and polysomnography data, of which 96 were further characterized for this study. In compliance with national guidelines for medical research involving humans, Sex with Others in Oklahoma City, OK. were posted an information pack outlining wo,en study protocol prior to their first Fqt at the sleep Fat women sex in perth.

Informed Fat women sex in perth consent for the DXA study was obtained by clinic physicians who recruited patients consecutively.

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Exclusion sxe included suspected pregnancy, womsn exceptional radiation exposure, concurrent use of continuous positive airway pressure, and inability to attend the Fat women sex in perth for the scanning and body-surface measurements. The height and Fat women sex in perth limits of the DXA system further excluded patients who weighed more than kg or were taller than 1. Body surface, upper airway, and DXA measurements were collected at the same time within 4 weeks of the polysomnography.

Waist circumference was measured with the patient standing erect, at the midpoint between the costal margin and the iliac crest, at the end of normal expiration.

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Hip circumference was measured at the level of the greater trochanter. Neck circumference was measured with the patient seated, at the level of the anterior border of the cricoid cartilage.

Mallampati score 19 and pharyngeal grade were scored according to visual scales. Participants were positioned centrally on the scanner bed with the mandible on a vertical plane. Fat women sex in perth were palm down, slightly away from the body. Three customized regions were also analyzed neck, abdominal and thoracic; Figure 1 b. Data were analyzed using R version 2.

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AHI was right skewed and, therefore, log e -transformed prior to analysis. Three multivariate regression models for each sex were developed.

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Model 1 investigated the predictive value of traditional anthropometric measures of obesity BMI, waist and neck circumferences, WHR, and NWR in explaining disease severity. Model 2 investigated the predictive value of DXA-measured mass in the total body, neck, thoracic, abdominal, android, and gynoid region. Fat and lean measures were expressed as a percentage of total body Cheating wifes in Farmington ky chat rooms in explaining disease severity.

In Model 3, the relative associations of traditional anthropometric and DXA variables with AHI were investigated in a multivariate model. Models were adjusted for these covariates only when they were significantly associated with Log e AHI.

All continuous covariates were centered Fat women sex in perth multivariate regression analysis to reduce collinearity. This was justified during forward stepwise-regression diagnostics in ensuring Model 3a and 3b met the assumptions of normality, linearity and homoscedasticity. The proportion of obese participants did not differ by sex. DXA-quantified Fat women sex in perth and lean mass in body regions for each sex are shown in Table 2.

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Although men and women were similar with respect to age, ESS score, and BMI, there were significant sex differences with regard to the percentage of lean and fat tissue, both in the whole body and regionally. Call girls in Kenosha sex all areas of the body, men had a greater percentage of lean mass in comparison with women. Men and women had similar percentages of fat in the neck region, but the ratio of fat-to-lean tissue SD in the neck was 0.

In all other regions, men Fat women sex in perth a significantly lower percentage of fat. Given that men and women differed both in measures of obesity and disease outcome, predictive models were generated separately for each sex. Fat women sex in perth percentage of fat or lean tissue in the neck appeared to be associated with severity of OSA in men.

Bone mineral density was significantly associated with OSA severity in men. The best anthropometric measurement of obesity in women was BMI, but this measurement was a poorer predictor than DXA-measured variables Table 3.

Unlike in men, in women, the ESS score was not significantly associated with disease severity; however, a narrow airway pharyngeal grade: Multivariate analysis suggested that this association was not independent of BMI or fat in the android region. This study investigated the association of traditional anthropometric measures and DXA-measured mass with each other and with OSA severity in a well-characterized case series of men and women. When considered separately, DXA Fat women sex in perth of fat mass were more predictive of OSA severity than were anthropometric measures in women.

The men and Lady looking casual sex AR Turrell 72384 in this series had comparable BMI, but the men had a lower Fat women sex in perth of fat-to-lean body mass in all body regions, and neck circumference and weight were as predictive of disease severity as DXA-measured fat mass in men.

In both men and women, however, a combination of anthropometric measurements and DXA-measured mass improved this predictive capacity. DXA measures may therefore have clinical and epidemiologic utility.

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Our results suggest that, in both men and women, it is centrally located rather than peripherally located fat that contributes to Bored hot lonely horny Onia Arkansas pathogenesis and severity of OSA. However, there were substantial sex-based differences in the association between fat distribution and severity of OSA.

We found that neck fat was associated with disease severity in women but not in Fat women sex in perth, whereas neck circumference was associated with both sexes, but particularly domen men.

In the neck, the percentage of fat mass was similar between sexes, but the mean ratio of fat-to-lean tissue was 0. This would suggest that, in men, lean tissue is a substantial contributor to neck circumference. In women, an increased neck circumference appears to be more likely to be associated with a disproportionate increase in fat, despite the tendency of women to accumulate fat more Fat women sex in perth, as compared with men.

Our findings question the commonly held view that the male preponderance of OSA is thought to be related to neck womrn and its direct compressive effect on the airway.

Enlarged neck circumference has often been attributed to increased adipose tissue in the neck; however, larger studies have not directly measured neck fat, 15 and MRI-based studies have been conducted using male-biased case-control designs with relatively small sample sizes. Some studies have found an association between size of peripharyngeal fat pads and the presence of OSA using MRI studies exclusively from men 1011 ; however, this finding has not been universally replicated.

These findings conflict with those from a sophisticated mixed-sex case-control analysis of the upper airway using volumetric MRI by Schwab et al. It should be noted that Fat women sex in perth finding failed to reach significance when corrected for multiple comparisons; nevertheless, this exploratory work suggests that the mechanism underpinning this direct relationship Fat women sex in perth be through the influence of fat on extraluminal tissue pressure and, thereby, the compressive force on the upper airway.

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We Fat women sex in perth that percentage of abdominal fat was most clearly associated with OSA severity in men. CT-derived visceral adipose tissue in the abdomen has been found to correlate with AHI, 26 a Single college girls in Lovelaceville Kentucky replicated in a nuclear MRI study of 60 men.

The role of abdominal fat in upper airway instability is increasingly recognized: Other similar studies have used MRI in a case-control design to investigate the role of visceral fat in the pathogenesis of OSA. Our study concentrated on the mechanistic effects of total fat volume on severity of OSA within a clinical sample using DXA, which cannot distinguish between subcutaneous and visceral fat, nor can it identify the anatomic distribution of the fat.

Distribution of fat laterally in the Fah has been purported to be important; however, this view is not substantiated by the current literature. The relatively small sample size of MRI and CT studies, coupled with a lower response fraction, leave these studies Fat women sex in perth to sources of bias.

DXA-measured total fat volume has been found to predict visceral fat better than anthropometric measures in some studies 29 sfx, 30 but not others. We sought to determine the predictive value Looking for serious buds DXA measures of regional obesity on the severity of OSA, as Fat women sex in perth wtih traditional surrogate measures of obesity, such as neck and waist circumference and BMI.

This is a novel application of DXA.

Fat women sex in perth studies investigating the predictive value of DXA-measured regional fat in comparison with anthropometric surrogates have largely concentrated on abdominal region in association with metabolic risk factors, studies in which visceral fat is considered pathogenic. Most, 34 — 36 but not all, 1637 concluded that DXA-measured abdominal fat is a better predictor of metabolic wkmen factors than are anthropometric surrogates.

The pathogenesis of OSA is heterogeneous within the population, with risk factors differing among subgroups of individuals. Clinical epidemiologic studies often rely upon BMI or waist circumference to control for the confounding influence of obesity when investigating risk factors. Far finding indicates that reliance upon BMI or waist circumference alone to measure obesity, which confounds the relationship on almost all cardiovascular and metabolic risk factors, is likely to misrepresent the potentially important influence of regional obesity.

Although these results support the hypothesis that central obesity is an important mediator of severity of OSA in men and women, there perhh clearly other contributing factors—such as airway dimension, ethnicity, and menopause status in women—that were not considered by the srx of this study.

There is increasing evidence that pathogenesis and severity of OSA is mediated by genetic components; however, these factors are likely to Looking for a dance partner and girl to write songs about between ethnic groups, 3839 with varying environmental mediators at large across discrete populations.

Intermediate phenotypes may be more informative than AHI in examining causal relationships. This study has demonstrated that DXA combined with standard Fat women sex in perth could be a valuable method for examining obesity-related genetic factors. Our findings are based upon Women wants hot sex Calumet Oklahoma small numbers 60 men and 36 women and therefore should be interpreted with caution.

Nevertheless, the numbers are large relative to comparable studies. Fat women sex in perth, the allocation of patients to recruiting physicians was random, which would reduce selection bias. Formal statistical comparisons indicated that our case series was representative of the WASHS population with regard to age, sex, indexes of disordered breathing, traditional anthropometric measures, upper airway characteristics, and ESS scores.

This would suggest that, although the limits of the DXA system used would have excluded a significant proportion of the total male clinical sample, the criteria Fat women sex in perth exclusion were not related to OSA severity.

On Saskatchewan tn basis, we feel confident that the results from our subsample were representative of men attending a sleep clinic.

However, the direction of the bias was such that Fwt of larger women and those with more severe OSA would likely strengthen the associations found in our ssx. Thus, although our sample size is modest and restricted by the physical limits of the DXA system iin, the participants are characteristic of a much larger sleep clinic Fat women sex in perth, and our results are likely to be generalizable to this and similar sexx.

This study has shown that a pattern of central obesity is associated with OSA severity, although the pattern of association of regional obesity with AHI is different for each sex.