Biomedical subjects

F W S Ko

Publications and source records attributed to F W S Ko.

14 recordsLinked to original sources

PubMed2006

Exhaled breath condensate levels of eotaxin and macrophage-derived chemokine in stable adult asthma patients.

BACKGROUND: Asthma is associated with esoinophilic airway inflammation and overproduction of T-helper type 2 (Th2) lymphocyte-related cytokines. OBJECTIVE: This study assessed the eosinophil chemoattractant eotaxin and Th2-specific macrophage-derived chemokine (MDC) in the adult asthmatic airway. Eotaxin and MDC levels were determined in exhaled breath condensate (EBC) obtained from adult patients with asthma. METHODS: Fifty-four asthmatics (20 male, mean (SD) age 40 (12) years and percentage predicted forced expiratory volume in 1 s (FEV(1)) 81.7 (20.8)) and 20 age- and sex-matched controls were studied. EBC was collected using EcoScreen by 10 min of tidal breathing with a nose clip. Concentrations of eotaxin and MDC were measured by ELISA. RESULTS: Asthma patients on inhaled corticosteroid (ICS) had a higher median interquartile range (IQR) level of eotaxin than the steroid-naïve asthmatics (18.5 (17.7-20.1) vs. 17.9 (17.0-18.6) pg/mL, P=0.02) and controls (18.5 (17.7-20.1) pg/mL vs 17.4 (16.3-18.0) pg/mL, P=0.001). Eotaxin level in EBC had a significant negative correlation with the FEV(1)/forced vital capacity ratio (r=-0.43, P=0.03) in steroid-naïve asthmatics. EBC MDC level was higher in subjects on ICS than the steroid naïve asthmatics (120 (118-125) vs. 117 (116-119) pg/mL, P=0.01) and the controls (120 (118-125) vs. 117 (116-120) pg/mL, P=0.02). CONCLUSIONS: Eotaxin and MDC could be measured in EBC of adults with asthma. EBC eotaxin and MDC levels were higher in asthmatics on ICS than the steroid-naïve asthmatics or controls. Exhaled chemokines may be potential non-invasive markers for assessing airway inflammation in asthmatics.

Administration, Inhalation↗

PubMed2006

Polymorphisms in manganese superoxide dismutase and catalase genes: functional study in Hong Kong Chinese asthma patients.

BACKGROUND: Reactive oxygen species may contribute to the pathogenesis of asthma. Functional genetic polymorphisms of antioxidant enzymes, superoxide dismutase (SOD) and catalase are good candidates for asthma susceptibility. OBJECTIVE: To investigate the association of the manganese-containing form of SOD (MnSOD) gene at amino acid position 16 (Val16Ala) and catalase gene in the promoter at A-21T and C-262T polymorphisms and asthma in a Hong Kong Chinese population. METHODS: The association study was conducted in a case-control design in asthma patients (n=251) and healthy controls (n=316) by genotyping. The functional significance was assessed by determining erythrocyte SOD and catalase activity. RESULTS: The Val allele of MnSOD at Val16Ala and the A allele of catalase gene at A-21T were not different between patients and controls, while the C allele of catalase gene at C-262T was found to be significantly different between patients and controls (P=0.033). The less frequent variant of catalase gene (-262T) was found to be protective from the development of asthma in a Hong Kong Chinese non-smoking population (adjusted odds ratio=0.35, 0.15-0.85; P=0.017). Asthma patients had elevated erythrocyte SOD and catalase activities in comparison with healthy controls (P<0.01). However, their activities were not associated with different genotypes within healthy controls or asthma patients. CONCLUSION: This is the first report showing that SOD and catalase functional activities are not associated with their respective genetic polymorphisms but related to the presence of asthma in a Hong Kong Chinese population.

Alleles↗

PubMed2006

Increasing COPD awareness.

Early diagnosis and smoking cessation are the only available methods to stop the progression of chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the effects of early detection of airflow limitation (AL) in a population with high risk for COPD, using spirometric screening. Smokers aged 40 yrs with a smoking history of 10 pack-yrs were invited to visit a local outpatient chest clinic for simple spirometry (forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)). Smoking history was recorded, followed by smoking cessation advice relating the results of spirometry to the smoking behaviour. Subjects who did not fulfil the above criteria (younger and/or nonsmokers) were also screened. A total 110,355 subjects were investigated; they were aged 53.5+/-11.5 yrs and 58.2% were males. Of the total amount of subjects, 64% were current smokers, 25.1% were former smokers and 10.9% were lifelong nonsmokers. Spirometry tests were within normal values for 70.3%, and 20.3% showed signs of AL: this was mild in 7.6%, moderate in 6.7% and severe in 5.9%. The remaining 8.3% of subjects presented with a restrictive pattern of ventilatory impairment. Airflow limitation was found in 23% of smokers aged 40 yrs with a history of 10 pack-yrs. This study concluded that large-scale voluntary spirometry screening of the population with high risk for COPD detects a large number of subjects with AL.

Adult↗

PubMed2005

Clinical and atopic parameters and airway inflammatory markers in childhood asthma: a factor analysis.

BACKGROUND: Recent studies have repeatedly shown weak correlations among lung function parameters, atopy, exhaled nitric oxide level (Feno), and airway inflammatory markers, suggesting that they are non-overlapping characteristics of asthma in adults. A study was undertaken to determine, using factor analysis, whether the above features represent separate dimensions of childhood asthma. METHODS: Clinically stable asthmatic patients aged 7-18 years underwent spirometric testing, methacholine bronchial challenge, blood sampling for atopy markers and chemokine levels (macrophage derived chemokine (MDC), thymus and activation regulated chemokine (TARC), and eotaxin), Feno, and chemokines (MDC and eotaxin) and leukotriene B(4) measurements in exhaled breath condensate (EBC). RESULTS: The mean (SD) forced expiratory volume in 1 second (FEV1) and Feno of 92 patients were 92.1 (15.9)% predicted and 87.3 (65.7) ppb, respectively. 59% of patients received inhaled corticosteroids. Factor analysis selected four different factors, explaining 55.5% of total variance. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.587. Plasma total and specific IgE levels, peripheral blood eosinophil percentage, and Feno loaded on factor 1; plasma TARC and MDC concentrations on factor 2; MDC, eotaxin and leukotriene B4 concentrations in EBC on factor 3; and plasma eotaxin concentration together with clinical indices including body mass index and disease severity score loaded on factor 4. Post hoc factor analyses revealed similar results when outliers were excluded. CONCLUSIONS: The results suggest that atopy related indices and airway inflammation are separate dimensions in the assessment of childhood asthma, and inflammatory markers in peripheral blood and EBC are non-overlapping factors of asthma.

Administration, Inhalation↗

PubMed2005

High levels and gender difference of exhaled nitric oxide in Chinese schoolchildren.

BACKGROUND: Exhaled nitric oxide (eNO) may represent a useful noninvasive marker of airway inflammation, but data on the reference population values in schoolchildren are limited. No reference eNO study in Asian children has been published. METHODS: Levels of eNO in a sample of 531 schoolchildren aged 11-18 years recruited from five schools (three international schools) in Hong Kong were measured online by a chemiluminescence analyser according to ERS/ATS standard. Each student also completed an International Study of Asthma and Allergic disease in Childhood questionnaire. RESULTS: Among the children without a physician's diagnosis of asthma or symptoms of wheeze, rhinitis and eczema, there were 258 Chinese and 33 Caucasians. In control Chinese children, the eNO level (median: interquantile range) was significantly higher (P<0.001) in males (17.0 parts per billion (p.p.b.); 10.7-36.6) than in females (10.8 p.p.b.; 7.8-17.6). When compared with Caucasian control males (11.6 p.p.b.; 8.2-19.3) and females (9.1 p.p.b.; 7.5-11.9), the Chinese children had significantly higher eNO levels for both males (P=0.011) and females (P=0.037). For Chinese asthmatic males, the median eNO (interquartile range) was 39.8 p.p.b. (12.5-73.8), and for asthmatic females, 18.0 (9.6-56.3). After controlling for sex in Chinese controls, eNO did not have any significant correlation with height, weight and body mass index or body surface area. CONCLUSIONS: This study demonstrates a gender difference of eNO level in healthy Chinese schoolchildren. When compared with Caucasians, Chinese children have significantly higher eNO levels.

Adolescent↗

PubMed2005

Nitric oxide synthase polymorphisms and asthma phenotypes in Chinese children.

BACKGROUND: Nitric oxide (NO) is a key factor for balancing T-helper type 1/T-helper type 2 immunity. Single nucleotide polymorphisms (SNPs) in nitric oxide synthase (NOS) genes have been associated with atopy and exhaled NO concentrations in Caucasians. We investigated the association between asthma traits and genetic polymorphisms in neuronal NO synthase (NOS1) and endothelial NO synthase (NOS3) in Chinese children. METHODS: Asthmatic children between 5 and 18 years of age and non-allergic controls were recruited. Plasma total IgE was measured by microparticle immunoassay, whereas allergen-specific IgEs were measured by fluorescent enzyme immunoassay. Fractional exhaled NO concentration (FeNO) was measured by a chemiluminescence analyser. NOS1 C5266T and NOS3 G894T were genotyped by restriction fragment length polymorphism, and (AAT)n polymorphism in intron 20 of NOS1 was determined by GeneScan analysis. RESULTS: The mean (SD) ages of 295 asthmatics and 174 controls were 11.1 (3.8) years and 11.6 (4.0) years, respectively (P=0.162). NOS1 C5266T and NOS3 G894T were not associated with asthma, atopy or FeNO. However, significantly more subjects with T/T in NOS1 C5266T had increased plasma total IgE as compared with those with C/T or C/C (P=0.017). This SNP was also associated with sensitization to Dermatophagoides pteronyssinus (P=0.049). Among asthmatic patients, log-transformed plasma total IgE levels were significantly higher among those homozygous for 5266T of NOS1 [mean (SD): 2.84 (0.44) for T/T, 2.68 (0.42) for C/T, 2.59 (0.69) for C/C; P=0.021]. This study found a significant inter-ethnic difference in the allele frequencies of AAT repeats, and this polymorphism was associated with high plasma total IgE levels (P=0.044) but not FeNO (P=0.158). NOS3 G894T was not associated with any asthma or atopy phenotype. CONCLUSIONS: NOS1 C5266T and AAT repeats affect plasma IgE concentrations in Chinese children. On the other hand, neither NOS1 nor NOS3 SNP was associated with FeNO or the risk of having asthma.

Adolescent↗

PubMed2005

Wheezing in Chinese schoolchildren: disease severity distribution and management practices, a community-based study in Hong Kong and Guangzhou.

BACKGROUND: Asthma is a common chronic disease and information on its management practices at the community level is helpful in identifying problems and improving asthma care. OBJECTIVE: To assess the severity status and management of the asthma symptom of wheeze of children at the community level in Hong Kong (HK) and Guangzhou (GZ). METHODS: Cross-sectional study of children aged 10 years using the International Study of Asthma and Allergic disease in Childhood (ISAAC Phase II protocol). Asthma management and lung function were assessed in 178 (98 from HK and 80 from GZ) randomly selected children with wheeze over the past 12 months. RESULTS: Eighty-three percent, 11%, 6% and 0% of children suffered from intermittent, mild persistent, moderate persistent and severe persistent asthma, respectively, according to the frequency of their symptoms. Addition of spirometric parameter only changed the asthma severity classification in 2.8% of children. Medications were used by 30.6% and 71.3% of children for wheeze in HK and GZ, respectively. In HK, inhaled beta(2)-agonist (73.3% among the drug users) was the commonest medication used followed by inhaled corticosteroid (ICS) (23.3%). In GZ, inhaled beta(2)-agonist was used by 75.4% of children, but use of ICS (26.3%), oral beta(2)-agonist (26.3%), oral theophylline (45.6%), oral ketotifen (36.8%) and oral steroid (35.1%) were also common. ICS was only used by 11.4% of children with persistent asthma. Ten percent and 18.7% of children in HK and GZ, respectively, had emergency department visits, while 16.3% and 11.6% of children in HK and GZ, respectively, had missed school secondary to asthma over the past 1 year. CONCLUSIONS: Most children in the community had intermittent asthma and addition of lung function to symptoms did not significantly affect classification of asthma severity. Significant morbidity was seen even in this group of children with mostly intermittent and mild persistent asthma.

Administration, Inhalation↗

PubMed2005

Increased expression of plasma and cell surface co-stimulatory molecules CTLA-4, CD28 and CD86 in adult patients with allergic asthma.

The co-stimulatory interactions of the B7 family molecules CD80 and CD86 on antigen-presenting cells, together with their T cell counter receptors CD28 and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), modulate T lymphocyte-mediated immune responses in a reciprocal manner. To investigate whether there is altered expression and the clinical significance of soluble co-stimulatory molecules in asthmatic patients, plasma concentrations of sCTLA-4, sCD28, sCD80 and sCD86 in 51 adult allergic asthmatic adults with or without steroid treatment, and 35 sex- and age-matched control subjects were measured by enzyme-linked immunosorbent assay (ELISA). Cell surface expression of CTLA-4 and CD28 on peripheral blood mononuclear cells (PBMC) were analysed by flow cytometry. Results showed that the plasma sCTLA-4 concentration was significantly higher in all asthmatic patients while sCD28 and sCD86 concentrations were significantly higher in steroid and non-steroid treated asthmatic patients, respectively, compared with control subjects (all P < 0.01). Significantly increased cell surface expression of CD28 but not CTLA-4 on PBMC was found in asthmatic patients compared with controls (P < 0.05). The plasma concentration and cell surface expression of CTLA-4 were found to exhibit positive and significant correlations with those of CD28 (both P < 0.05). Serum total IgE concentration correlated positively and significantly with sCTLA-4 and sCD28 concentrations in allergic asthmatic patients (both P < 0.05). The increased expression of these soluble co-stimulatory molecules may reflect the dysregulation of T cell activation, thereby contributing to the immunopathogenesis of allergic asthma.

Adult↗

PubMed2005

Sputum bacteriology in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease and concomitant pneumonia in Hong Kong.

AIM: To study the sputum microbiology of patients admitted to a teaching hospital with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) with concomitant pneumonia. METHODS: This was a retrospective study in a tertiary university hospital in Hong Kong. All episodes of AECOPD with pneumonia, patient demographics, length of stay, sputum culture and radiological results admitted in the first half of the year 2000 were retrieved from hospital records. RESULTS: There were 118 patients (91 male) with 150 episodes of AECOPD with concomitant pneumonia. The age of the patients was 74.8 +/- 10.0 years. Positive routine sputum culture was detected in 45.6% of the patients. Among these hospital admissions, 8.7, 4.0 and 12.0%, respectively, required intensive care unit admissions, mechanical ventilation and non-invasive positive pressure ventilation. Haemophilus influenzae was the commonest organism found in sputum (26.0%), followed by Pseudomonas aeruginosa (5.5%), Streptococcus pneumoniae (3.4%), and Moraxella catarrhalis (3.4%). Mycobacterium tuberculosis was found in 1.5% of the admissions. The presence of P. aeruginosa in sputum was associated with a longer hospital length of stay (9.1 +/- 3.1 vs. 7.1 +/- 4.2 days, P = 0.03). CONCLUSION: In contrast to most other studies reporting S. pneumoniae as the most likely bacterial pathogen, H. influenzae was the commonest bacterium isolated in sputum in our patients with AECOPD and concomitant pneumonia.

Acute Disease↗

PubMed2004

Declining asthma prevalence in Hong Kong Chinese schoolchildren.

BACKGROUND: Many studies have reported an increase in the prevalence of asthma and related atopic disorders. The lack of standardized methodologies and 'objective' measurements make reliable comparison and monitoring of trends of asthma very difficult. METHODS: In this study, a total of 3321 schoolchildren aged 13-14 years were recruited for study using the Phase III Protocol of the International Study of Asthma and Allergic disease in Childhood (ISAAC). The results were compared with those obtained in the Phase I ISAAC study (1994-95), which used the identical and validated core questionnaires. RESULTS: The prevalence rates of physicians' diagnosis of asthma were similar in the two surveys (11.2% and 10.2%), but the prevalence rates of wheeze (written questionnaire) in the past year have decreased from 12.4% in 1994-95 to 8.7% in 2002 (P<0.001). For the video questionnaire, all asthmatic symptoms in the preceding 12 months were significantly lower in 2002 when compared with those in 1994-95. Among the subjects with diagnosed asthma, the prevalence rates of wheeze in the past 12 months (written questionnaire) has decreased from 39.1% to 27.6% (P<0.001). The prevalence rates of having wheezing attack at least once per month (video questionnaire) has decreased from 10.5% to 5.6% (P=0.013). CONCLUSION: Using the same standardized and validated ISAAC questionnaire, the prevalence rates of asthma symptoms in Hong Kong Chinese schoolchildren have decreased since 1994. The exact reasons for such trend remain to be explored.

Adolescent↗

PubMed2004

Increased macrophage-derived chemokine in exhaled breath condensate and plasma from children with asthma.

BACKGROUND: Type 2 helper T lymphocyte-specific chemokines including macrophage-derived chemokine (MDC), thymus and activation-regulated chemokine (TARC) and eotaxin are important mediators for allergic airway inflammation. OBJECTIVE: We investigated whether these chemokines can be detected in exhaled breath condensate (EBC) and their relation to childhood asthma. METHODS: Asthmatics recruited from paediatric clinics of a university teaching hospital were classified into intermittent asthma (IA) and persistent asthma (PA) according to Global Initiative for Asthma guidelines. EBC was collected by a disposable collection kit, whereas fractional exhaled nitric oxide (FENO) was measured by a chemiluminescence analyser. Concentrations of MDC, TARC and eotaxin in both EBC and plasma were measured using sandwich enzyme immunoassay. The intra-subject reproducibility of exhaled chemokine measurements was determined by co-efficients of variation (CV). RESULTS: Forty-eight patients with PA, 36 children with IA and 18 controls were recruited. MDC and eotaxin were present in EBC from nearly all subjects, whereas TARC could be measured in EBC from 33 (32%) subjects only. The median MDC concentration in EBC was higher in PA (117 pg/mL) as compared with IA (106 pg/mL) and controls (105 pg/mL; P=0.003 for both). The median plasma MDC concentration in PA (648 pg/mL) was also higher than that in IA (520 pg/mL; P=0.002) and controls (490 pg/mL; P=0.008). The median plasma TARC concentration was also increased in PA as compared with IA (72 pg/mL vs. 35 pg/mL; P=0.004). MDC concentrations in EBC were lower in patients with PA who received high-dose inhaled corticosteroid (P=0.005). FENO was significantly higher in asthmatics than controls (P<0.0001), but it was not associated with chemokines in EBC or plasma. The mean (range) CV for measuring MDC, TARC and eotaxin in EBC (n=6) were 5.5 (2.0-7.2%), 8.8 (3.6-14.4%) and 5.2 (2.8-7.9%), respectively. CONCLUSIONS: Our results suggest that MDC in EBC and MDC and TARC in plasma are increased in children with PA as compared with IA or control. MDC concentrations in EBC are suppressed in patients on high-dose inhaled corticosteroid treatment.

Adolescent↗

PubMed2003

Cephalometric assessment of craniofacial morphology in Chinese patients with obstructive sleep apnoea.

OBJECTIVE: To compare the differences in craniofacial morphology in Chinese patients with and without obstructive sleep apnoea (OSA). METHOD: We performed lateral cephalometric radiographs on 94 consecutive patients (77 males) referred with snoring or other symptoms suggestive of OSA for polysomnography (PSG). Significant OSA was defined as an apneoa-hypopnoea index (AHI) > or = 10/h of sleep on overnight PSG. The cephalometric data were compared between those with and without significant OSA. RESULTS: (mean +/- SD) There were 69 (56 males) with significant OSA with mean age 53 +/- 12 years, body mass index (BMI) 28.6 +/- 5.0 kg/m2, AHI 36.5 +/- 20.6/h, and minimum SaO2 76 +/- 14%. There were 25 controls (21 males) without significant OSA with similar age and BMI. The mandibular plane to hyoid bone distance (MPH) and the perpendicular distance from hyoid bone to the line connecting C3 vertebra and retrognathion (HHI) were significantly longer in the OSA patients. The angle measurement from sella to nasion to point A (SNA) was smaller in the OSA group. MPH distance was the only independent variable for significant OSA with an odds ratio of 3.47 (95% CI 1.39-8.66). Abnormalities of the MPH and SNA were more marked in the OSA patients with BMI > or = 30 kg/m2. CONCLUSIONS: Significant differences in craniofacial morphology are noted between OSA patients and non-apnoeic controls. An inferiorly positioned hyoid bone and a retropositioned maxilla may predispose obese patients to more severe OSA.

Analysis of Variance↗

PubMed2002

Prevalence of wheeze, bronchial hyper-responsiveness and asthma in the elderly Chinese.

BACKGROUND: Asthma is a common health problem affecting patients of all ages. Because of the ease of sampling, epidemiological studies have concentrated mainly on the paediatric and general population. OBJECTIVE: This study aimed to determine the prevalence of wheeze, bronchial hyper-responsiveness and asthma amongst our elderly population and deduce any clinical and laboratory risk factors that might identify elderly asthmatics at an earlier stage. METHODS: Two thousand and thirty-two elderly Chinese aged > or = 70 years, randomly selected from a registered list of all recipients of Old Age and Disability Allowances in Hong Kong, were administered a questionnaire on lung health. Two hundred and fifty subjects were invited to attend our laboratory for skin tests and pulmonary function tests and 179 agreed. Of these, 173 (96.6%) and 176 (98.3%) had eosinophil count and serum IgE levels measured, respectively. Two definitions of asthma were used: (1) bronchial hyper-responsiveness (BHR) plus current wheeze, and (2) history of wheezing without previous diagnostic labels of emphysema or chronic bronchitis. RESULTS: Fifteen patients (out of 179: 8.4%) reported wheezing over the past 1 year. Fifty-one patients (28.5%) demonstrated BHR on spirometry or histamine challenge tests. Seven patients had both symptoms of wheezing and evidence of BHR. The prevalence of asthma using this definition is therefore 3.9% (95% CI 1.6-7.9%). Nine patients had symptoms of wheezing without previous diagnostic labels of chronic bronchitis or emphysema and, using this definition, the prevalence is 5.0% (95% CI 2.3-9.3%). Using multiple logistic regression studies, sex, social class, age, smoking habits, serum IgE levels and eosinophil counts did not predict a diagnosis of asthma using either definition. We found no association between a positive skin test and any respiratory symptoms or illnesses including asthma. CONCLUSION: Wheeze, bronchial hyper-responsiveness and asthma are prevalent amongst our elderly population. However, there were no identifiable demographic and laboratory risk factors in this study that may help us predict a diagnosis of asthma.

Aged↗

PubMed2002

Prevalence of snoring and sleep-disordered breathing in a group of commercial bus drivers in Hong Kong.

OBJECTIVES: To assess the prevalence of sleep-disordered breathing (SDB) and its associated symptoms in a group of commercial bus drivers in Hong Kong. METHODS: Two hundred and sixteen of 410 bus drivers from three different shifts were interviewed with the Sleep & Health Questionnaire (SHQ) and the Epworth sleepiness scale (ESS) at a Hong Kong bus depot. Seventeen subjects from each shift were then randomly selected for at-home sleep study using the Mesam IV device (Madaus Medizin-Elektronik, Freiburg, Germany). RESULTS: There were 207 men and nine women (mean age 42.4 +/- 7.5 years; body mass index (BMI) 25.4 +/- 4.5 kg/m2; ESS 5.3 +/- 4.2). From the SHQ it was discovered that: (i) daytime sleepiness was reported by 87 subjects (40%), (ii) snoring > or = 3 times per week was reported by 80 subjects (37%), (iii) witnessed apnoea was reported by 17 subjects (7.9%) and (iv) 29 subjects (13.4%) reported having fallen asleep during driving. Among the 51 subjects who underwent the at-home sleep study: (i) 31 subjects (61%) had respiratory disturbance index (RDI) > or = 5 per hour of sleep, (ii) 21 subjects (41%) had RDI > or = 10 per hour of sleep, (iii) 12 subjects (24%) had RDI > or = 15 per hour of sleep and (iv) 35 subjects (68.6%) snored objectively > or = 10% of the night. Ten subjects (20%) had RDI > or = 5 and sleepiness at work, while five subjects (9.8%) had RDI > or = 5 and ESS > 10. No significant differences were noted in the SHQ responses, ESS, objective snoring or RDI among the three groups. Multiple regression analysis showed that BMI and witnessed apnoea were the only positive independent predictors of RDI. CONCLUSIONS: This study showed a high prevalence of objective snoring and SDB in a group of commercial bus drivers. Neither self-reported sleepiness nor the ESS could identify subjects with SDB.

Adult↗