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Sleep-disordered breathing and proteinuria in overweight and obese children and adolescents

S L Verhulst1, K Van Hoeck, N Schrauwen

  • 1Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium. stijn.verhulst@ua.ac.be

Hormone Research
|September 6, 2008
PubMed

Insights

In overweight children, insulin resistance, not sleep-disordered breathing (SDB), is linked to early kidney dysfunction markers like albuminuria. This study highlights metabolic factors over breathing issues in pediatric renal health.

Area of Science:

  • Pediatric Nephrology
  • Metabolic Syndrome in Children
  • Sleep Medicine

Background:

  • Overweight and obesity in children are associated with increased risk of early kidney dysfunction.
  • Sleep-disordered breathing (SDB) is common in obese children and may contribute to metabolic disturbances.
  • Urinary albumin and protein loss are sensitive markers for detecting early renal impairment.

Purpose of the Study:

  • To investigate if sleep-disordered breathing (SDB) exacerbates urinary albumin and protein loss in overweight/obese children.
  • To determine the relationship between SDB parameters and markers of early kidney dysfunction.
  • To explore the role of insulin resistance in this context.

Main Methods:

  • Prospective study of overweight and obese children and adolescents.
  • Inclusion of anthropometry, oral glucose tolerance tests, and polysomnography.
  • Calculation of albumin excretion rate and urinary protein to creatinine ratio (UPCR) from 24-hour urine collections.

Main Results:

  • No significant difference in albuminuria or UPCR was found between subjects with and without SDB.
  • SDB parameters did not correlate with markers of kidney dysfunction.
  • Albuminuria correlated with insulin resistance markers (fasting/post-challenge glucose, insulin, C-peptide), with post-challenge glucose being a key predictor.

Conclusions:

  • Insulin resistance, indicated by elevated glucose levels, is associated with increased albuminuria in overweight/obese youth.
  • SDB does not appear to be an independent risk factor for early renal dysfunction in this population.
  • Findings suggest metabolic dysregulation is a primary driver of renal changes in pediatric obesity.
Abstract

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