Association between morphometric variables and nocturnal
               desaturation in sickle-cell anemia

Salles, Cristina; Bispo, Marcelo; Trindade-Ramos, Regina Terse

doi:10.1016/j.jped.2014.01.005

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Original Articles • J. Pediatr. (Rio J.) 90 (4) • Jul-Aug 2014 • https://doi.org/10.1016/j.jped.2014.01.005 copy

Association between morphometric variables and nocturnal desaturation in sickle-cell anemia ^☆ ☆ Please cite this article as: Salles C, Bispo M, Trindade-Ramos RT. Association between morphometric variables and nocturnal desaturation in sickle-cell anemia. J Pediatr (Rio J). 2014;90:420-5.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to evaluate associations between morphometric variables, cervical circumference (CC), and abdominal circumference (AC) with the presence of nocturnal desaturation in children and adolescents with sickle-cell anemia.

METHODS:

all patients were submitted to baseline polysomnography, oral cavity measurements (maxillary intermolar distance, mandibular intermolar distance, and overjet), and CC and AC measurements.

RESULTS:

a total of 85 patients were evaluated. A positive correlation was observed between the height/age Z-score and CC measurement (r = 0.233, p = 0.031). The presence of nocturnal desaturation was associated with CC (59.2± 9.3 vs. 67.5 ± 10.7, p = 0.006) and AC measurements (27.0 ± 2.0 vs. 29.0± 2.1, p = 0.028). There was a negative correlation between desaturation and maxillary intermolar distance (r = -0.365, p = 0.001) and mandibular intermolar distance (r = -0.233, p = 0.037).

CONCLUSIONS:

the morphometric variables of CC and AC may contribute to raise suspicion of nocturnal desaturation in children and adolescents with sickle-cell anemia.

Sickle-cell anemia; Desaturation; Maxilla; Mandible; Sleep apnea

Variable	Apneic (n = 9)	Non-apneic (n = 76)	p^a
Age, years	9 ± 4	9 ± 3	0.818
Mean annual hemoglobin, g/dL	7.6 ± 0.6	7.9 ± 2	0.295
Z-score for body mass index	-0.4 (-2.8-0.5)	-1.0 (-2.2 to -0.2)	0.875
Z-score for height/age	-0.5 (-1.7-0.9)	-0.7 (-1.4 to -0.1)	0.775
Episodes of pain in the last 12 months, n	12 (3-26)	20 (4-60)	0.936
Size of pharyngeal tonsils, % of cavum occupancy	90 (25-95)	60 (40-70)	0.135

Variable	Apneic (n = 9)	Non-apneic (n = 76)	p
TST, Min^a	332 ± 79	368 ± 63	0.223
AHI (events/h of sleep)^a	1.3 (1.9–5.1)	0 (0–0)	0.000
Micro-arousals, events/h of sleep^a	57 (30–147)	43 (29–67)	0.145
Desaturations, events/h of sleep^a	13 (1.5–29)	5 (1–11)	0.083
Time of SpO₂ < 90%^and	10 (1–29)	0.6 (0.1–4.9)	0.105
Time of SpO₂ < 80%^and	0.1 (0–2)	0 (0–0)	0.021

Variable	With desaturation (n = 69)	Without desaturation (n = 16)	p
Age (years)^a	9.0 ± 3.8	10.6 ± 4.6	0.229
Abdominal circumference, cm^a	59.2 ± 9.3	67.5 ± 10.7	0.006
Cervical circumference, cm^a	27.0 ± 2.0	29.0 ± 2.1	0.028
Size of mandible, cm^a	3.3 ± 0.4	3.7 ± 0.6	0.007
Size of maxilla, cm^a	3.6 ± 0.4	3.8 ± 0.5	0.048
Overjet, mm^b	0.3 (0–0.6)	0.6 (0.3–0.9)	0.081

Morphometric variables	R	p
Cervical circumference vs. nocturnal desaturation ^a	-0.278	0.012
Abdominal circumference vs. nocturnal desaturation ^a	-0.188	0.092
Overjet vs. nocturnal desaturation ^a	-0.178	0.115
Size of mandible vs. nocturnal desaturation ^a	-0.233	0.037
Size of maxilla vs. nocturnal desaturation ^a	-0.365	0.001
Z-score height/age vs. cervical circumference ^a	0.233	0.031

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[1] * Corresponding author. E-mail: draçristinasalles@gmail.com (C. Salles).

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Association between morphometric variables and nocturnal desaturation in sickle-cell anemia ☆ ☆ Please cite this article as: Salles C, Bispo M, Trindade-Ramos RT. Association between morphometric variables and nocturnal desaturation in sickle-cell anemia. J Pediatr (Rio J). 2014;90:420-5.

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Association between morphometric variables and nocturnal desaturation in sickle-cell anemia ^☆ ☆ Please cite this article as: Salles C, Bispo M, Trindade-Ramos RT. Association between morphometric variables and nocturnal desaturation in sickle-cell anemia. J Pediatr (Rio J). 2014;90:420-5.