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a Division of
Respiratory Medicine, Royal University Hospital, Saskatoon,
Saskatchewan, Canada S7N 0W8, b Regina
Health District, Regina, Saskatchewan, Canada
Correspondence to: Dr R Jokic, Department of Psychiatry, Royal University Hospital, Saskatoon, Saskatchewan, Canada, S7N 0W8 rjokic{at}sk.sympatico.ca
Received 5 November 1999; Returned to authors 13 March 2000; Revised version received 5 June 2000; Accepted for publication 8 August 2000
BACKGROUND
It is
unclear why some morbidly obese individuals have waking alveolar
hypoventilation while others with similar obesity do not. Some evidence
suggests that patients with the obesity hypoventilation syndrome (OHS)
may have a measurable premorbid impairment of ventilatory chemoresponsiveness. Such an impairment of ventilatory
chemoresponsiveness in OHS, however, may be an acquired and
reversible consequence of severe obstructive sleep apnoea (OSA). We
hypothesised that, in patients with OHS who do not have coincident
severe OSA, there may be a familial impairment in ventilatory responses
to hypoxia and hypercapnia.
METHODSSixteen first
degree relatives of seven patients with OHS without severe OSA (mean
(SD) age 40 (16) years, body mass index (BMI) 30 (6) kg/m2) and 16 subjects matched for age and BMI without
OHS or OSA were studied. Selection criteria included normal arterial
blood gas tensions and lung function tests and absence of sleep apnoea
on overnight polysomnography. Ventilatory responses to isocapnic hypoxia and to hyperoxic hypercapnia were compared between the two groups.
RESULTSThe slope of
the ventilatory response to hypercapnia was similar in the relatives
(mean 2.33 l/min/mm Hg) and in the control subjects
(2.12 l/min/mm Hg), mean difference 0.2 l/min/mm Hg, 95%
confidence interval (CI) for the difference -0.5 to 0.9 l/min/mm Hg,
p=0.5. The hypoxic ventilatory response was also similar between the two groups (slope factor A: 379.1 l/min 
mm Hg for relatives and 373.4 l/min mm Hg for controls; mean difference 5.7 l/min mm Hg; 95% CI -282 to 293 l/min mm Hg, p=0.7; slope of the linear regression line of the fall in oxygen saturation and increase in
minute ventilation: 2.01 l/min/% desaturation in relatives, 1.15 l/min/% desaturation in controls; mean difference 0.5 l/min/% desaturation; 95% CI -1.7 to 0.7 l/min/% desaturation, p=0.8).
CONCLUSIONThere is no
evidence of impaired ventilatory chemoresponsiveness in first degree
relatives of patients with OHS compared with age and BMI matched
control subjects.
This article has been cited by other articles:
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