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Published on: December 6, 2016
Identifying Pathways Mediating Obstructive Sleep Apnea and Obesity in Indian Children
Giulia Lorenzoni1, Danila Azzolina1, Gulshan Sethi2
1Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
Insights
Obstructive sleep apnea (OSA) in obese Indian children was studied. While OSA was linked to higher glucose levels, it did not significantly affect insulin resistance or catecholamines, with age being a key factor in metabolic outcomes.
Area of Science:
- Pediatric Endocrinology
- Sleep Medicine
- Metabolic Syndrome
Background:
- Childhood obesity is a growing concern linked to metabolic and cardiovascular issues.
- Obstructive sleep apnea (OSA) is a common comorbidity in obese children, but its metabolic impact is not fully understood.
Purpose of the Study:
- To investigate the association between obstructive sleep apnea (OSA) and obesity-related metabolic outcomes in obese Indian children.
- To explore the relationship between polysomnographic parameters and metabolic markers like insulin resistance, adiponectin, and urinary catecholamines.
Main Methods:
- An observational, cross-sectional study enrolled obese children suspected of OSA.
- Obstructive sleep apnea (OSA) was diagnosed using polysomnography.
- Insulin resistance was assessed using Homeostasis Model Assessment (HOMA), with HOMA > 4.39 indicating resistance.
Main Results:
- Of 45 obese children, 29 had OSA. OSA children showed significantly higher glucose levels (p=0.012) but no differences in insulin resistance or urinary catecholamines.
- No significant associations were found between polysomnographic measures and HOMA or adiponectin.
- Older age was associated with lower catecholamine levels and was the only significant factor linked to HOMA (p=0.03) and adiponectin (p=0.01).
Conclusions:
- Understanding OSA's role in obese children's metabolic health is vital for developing targeted prevention strategies.
- Early identification and management of OSA may be important for mitigating metabolic complications in childhood obesity.
Objective:
Overweight and obesity in children is associated with several metabolic and cardiovascular impairments, including obstructive sleep apnea (OSA). However, the causal pathway from OSA to obesity is not fully known yet. The aim of this study was to explore the association between OSA and obesity-related metabolic outcomes in obese Indian children.
Methods:
An observational, cross-sectional study was conducted. Obese children referred to the Otorhinolaryngology Department at the Maulana Azad Medical College (New Delhi, India) for suspicion of OSA were consecutively enrolled. OSA was diagnosed by polysomnographic parameters. Homeostasis model assessment (HOMA) was calculated to measure insulin sensitivity and HOMA > 4.39 was considered as a threshold for insulin resistance. The association between various polysomnographic measures and HOMA, adiponectin and various urinary catecholamines was assessed.
Results:
Complete polysomnographic parameters were available for 45 children; of these 29 were found to suffer from OSA. OSA children had significantly higher glucose concentrations compared to non-OSA ones (p value = 0.012) but no differences were found in insulin resistance and urinary catecholamines levels. Older age was significantly associated to lower levels of catecholamines. No significant associations were found between polysomnographic parameters and both HOMA and adiponectin. Only age was found to be significantly associated with HOMA (p = 0.03) and adiponectin (p = 0.01).
Conclusions:
A better understanding of the role played by OSA on obese children's metabolic functions is crucial to implement specific prevention strategies to reduce the public health burden of non-communicable diseases.
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