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Is sleep-disordered breathing an additional risk factor for the metabolic syndrome in obese children and adolescents?

S L Verhulst1, R Rooman, L Van Gaal

  • 1Department of Pediatrics, University of Antwerp-Campus Drie Eiken, Universiteitsplein 1,Wilrijk, Belgium. stijn.verhulst@ua.ac.be

International Journal of Obesity (2005)
|September 10, 2008
PubMed

Insights

Childhood obesity is linked to sleep-disordered breathing and metabolic syndrome. Current evidence does not confirm a causal relationship between sleep apnea and insulin resistance, necessitating further research.

Area of Science:

  • Pediatric Endocrinology
  • Sleep Medicine
  • Metabolic Disorders

Background:

  • Sleep-disordered breathing (SDB) is common in childhood obesity.
  • SDB is independently associated with metabolic syndrome.
  • The link between SDB and insulin resistance, a key metabolic syndrome component, is under investigation.

Purpose of the Study:

  • To review the current evidence on the association between sleep-disordered breathing and insulin resistance in children.
  • To evaluate the consistency of findings across different weight categories and study designs.

Main Methods:

  • Systematic review of cross-sectional and treatment studies.
  • Analysis of correlations between SDB severity and metabolic syndrome markers.
  • Examination of insulin resistance in relation to SDB in normal-weight, modestly obese, and morbidly obese children.

Main Results:

  • Cross-sectional studies suggest an association between sleep apnea and insulin resistance in modestly obese children.
  • This association was not consistently found in normal-weight or morbidly obese children.
  • Treatment studies (adenotonsillectomy) yielded conflicting results regarding the SDB-insulin resistance link, even in obese children.

Conclusions:

  • Existing evidence is insufficient to establish a causal link between sleep-disordered breathing and insulin resistance in children.
  • Contradictory findings may stem from statistical power limitations and varying patient characteristics.
  • Longitudinal studies and randomized controlled trials are crucial for future research.

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