ABSTRACT BACKGROUND: Neck circumference (NC) is a useful anthropometric measure for predicting obstructive sleep apnea (OSA). Ethnicity and sex also influence obesity phenotypes. NC cut-offs for defining OSA have not been established for the Latin American population. OBJECTIVES: To evaluate NC, waist circumference (WC), and body mass index (BMI) as predictors of OSA in the Colombian population and to determine optimal cut-off points. DESIGN AND SETTING: Diagnostic tests were conducted at the Javeriana University, Bogota. METHODS: Adults from three cities in Colombia were included. NC, WC, and BMI were measured, and a polysomnogram provided the reference standard. The discrimination capacity and best cut-off points for diagnosing OSA were calculated. RESULTS: 964 patients were included (57.7% men; median age, 58 years) and 43.4% had OSA. The discrimination capacity of NC was similar for men and women (area under curve, AUC 0.63 versus 0.66, P = 0.39) but better for women under 60 years old (AUC 0.69 versus 0.57, P < 0.05). WC had better discrimination capacity for women (AUC 0.69 versus 0.57, P < 0.001). There were no significant differences in BMI. Optimal NC cut-off points were 36.5 cm for women (sensitivity [S]: 71.7%, specificity [E]: 55.3%) and 41 cm for men (S: 56%, E: 62%); and for WC, 97 cm for women (S: 65%, E: 69%) and 99 cm for men (S: 53%, E: 58%). CONCLUSIONS: NC and WC have moderate discrimination capacities for diagnosing OSA. The cut-off values suggest differences between Latin- and North American as well as Asian populations.

Periodontal disease and its inflammatory response have been related to adverse outcomes in pregnancy such as preterm birth, preeclampsia and low birth weight. This study analyzed systemic inflammatory response in patients with high risk of preterm delivery and its relationship to periodontal disease. A pilot study was conducted for a case and control study, on 23 patients at risk of preterm delivery and 23 patients without risk of preterm delivery as controls. Exclusion criteria were patients who had received periodontal treatment, antibiotic or antimicrobial agents within the past three months, or with infections or baseline diseases such as diabetes or hypercholesterolemia. All patients underwent periodontal assessment, laboratory tests (complete blood count, lipid profile, baseline glycemia) and quantification of cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α and TNF-γ). Higher levels of pro-inflammatory cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α and TNF-γ) were found in patients with chronic periodontitis than in patients with gingivitis or periodontal health. These cytokines, in particular IL-2, IL-10 and TNF-α, were higher in patients at high risk of preterm delivery. Patients with high risk of preterm delivery had higher severity of periodontal disease as well as higher levels of the pro-inflammatory markers IL-2, IL-4, IL-6, IL-10, TNF-α and TNF-γ.

La enfermedad periodontal y su repuesta inflamatoria ha sido relacionada con desenlaces adversos del embarazo como el parto pretérmino, preeclampsia y bajo peso al nacer. La presente investigación analizó la respuesta inflamatoria sistèmica en pacientes embarazadas con alto riesgo de parto pretérmino y su relación con la enfermedad periodontal. Se realizó un estudio piloto de casos y controles, en el cual se contó con 23 pacientes que presentaban riesgo de parto pretérmino como casos y 23 pacientes sin riesgo de parto pretérmino como controles. Fueron excluidas las pacientes que hubieran recibido tratamiento periodontal, antibióticos o antimicrobianos en los últimos tres meses, que tuvieran infecciones, o enfermedades de base como diabetes o hipercolesterolemia. A todas las pacientes se les hicieron valoración periodontal, exámenes de laboratorio (cuadro hemático, perfil lipídico, glucemia basal) y cuanti-ficación de citocinas (IL-2, IL-4, IL-6, IL-10, TNF-α e TNF-γ). En las pacientes con periodontitis crónica se encontraron niveles más elevados en las citocinas proinflamatorias (IL-2, IL-4, IL-6, IL-10, TNF-α e TNF-γ) en comparación con las pacientes con gingivitis o sanas periodontales. Estas citocinas se encontraron más elevadas en las pacientes con alto riesgo de parto pretérmino, en especial la IL-2, IL-10 y TNF-α. Las pacientes con alto riesgo de parto pretérmino presentaron mayor severidad de la enfermedad periodontal y adicionalmente niveles aumentados de los marcadores pro inflamatorios IL-2, IL-4, IL-6, IL-10, TNF-α e TNF-γ.