From the authors:
We thank P.R. Genta and G. Lorenzi-Filho for their interest in and comments on our study [1]. One of our major findings was that the prevalence of sleep-disordered breathing (SDB) was similar among the community-based samples of Caucasians, Hispanics and Japanese within the same body mass index (BMI) stratum. However, a major point of the critique from P.R. Genta and G. Lorenzi-Filho was that ethnic differences in body fat composition need to be considered when comparing the prevalence or severity of SDB. Based on their clinical findings [2], they suggested using different cut-offs for defining obesity (i.e. ≥30 kg·m−2 for Caucasians and ≥25 kg·m−2 for Asians).
In response to P.R. Genta and G. Lorenzi-Filho we recalculated the prevalence of SDB by ethnicity using their recommended dichotomous obesity cut-offs. The SDB prevalence remained higher among Americans than Japanese regardless of obesity stratum. In the re-defined obese stratum, SDB prevalence was 21% for Japanese, 40% for Hispanics (p<0.001 for difference from Japanese) and 44% for white Americans (p<0.001); and in the non-obese stratum, 17% for Japanese, 32% for Hispanics (p = 0.001) and 27% for Whites (p = 0.01). These findings do not support their hypothesis that Japanese have higher SDB prevalence within these new obesity categories.
We agree that BMI may not be the best body composition marker to compare ethnicities; however, no better markers than BMI have been reported for the general population. Further cross-cultural studies in community settings should be performed to address this issue.
Footnotes
Statement of Interest
None declared.
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