Adipokines in children with sleep disordered breathing.

Area of Science:

• Pediatric Endocrinology
• Sleep Medicine
• Metabolic Health

Background:

• Associations between sleep-disordered breathing (SDB), metabolic syndrome, and adipokines are known in adults.
• Snoring children exhibit insulin resistance and lipid abnormalities related to adiposity, unlike adults.
• Limited research exists on adipokines, insulin resistance, and SDB in pediatric populations.

Purpose of the Study:

• To investigate the relationship between circulating adipokine levels, insulin resistance, and SDB measures in children.
• To determine if SDB influences adipokine profiles in pediatric subjects.
• To explore the role of adiposity versus SDB in metabolic alterations in children.

Main Methods:

• Prospective study design.
• Polysomnography for SDB assessment.
• Measurement of plasma adipokines (leptin, adiponectin, resistin), glucose, insulin, and C-reactive protein (CRP).
• Analysis of 130 children, including obese and non-obese participants.

Main Results:

• Adiponectin levels were lower in obese children and inversely correlated with BMI Z scores, but not with apnea-hypopnea index (AHI).
• Leptin levels were higher in obese children, correlated with BMI Z scores, and lower in children with lower AHI and higher oxygen saturation.
• Leptin levels showed a strong positive correlation with insulin/glucose ratios, while adiponectin showed a negative correlation.

Conclusions:

• Circulating adipokine levels in children are primarily influenced by body weight (ponderal index).
• Sleep-disordered breathing and associated hypoxemia may contribute to elevated leptin levels in children.
• The findings suggest that adiposity, rather than SDB, is the main driver of insulin resistance and metabolic changes in snoring children.