Effects of sleep-disordered breathing on serum lipid levels in children:a case control study
Lei Lei1, XiaoYun Zhang1, Binbin Wang1
1Department of Otorhinolaryngology, Head&Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Sichuan, China.
Insights
Childhood sleep-disordered breathing (SDB) significantly impacts blood lipids. Even primary snoring (PS) elevates lipid levels, contrary to previous beliefs, with obesity affecting triglyceride levels.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Clinical Biochemistry
Background:
- Childhood sleep-disordered breathing (SDB) encompasses primary snoring (PS) and obstructive sleep apnea syndrome (OSAS).
- While OSAS is linked to health issues, PS was considered less harmful.
- Emerging evidence suggests PS may also contribute to cardiovascular, cognitive, and behavioral problems.
Purpose of the Study:
- To investigate the association between serum lipid profiles and SDB components in children.
- To compare lipid levels in children with OSAS, PS, and healthy controls.
- To explore the role of obesity in SDB and lipid metabolism.
Main Methods:
- Cross-sectional study involving children with habitual snoring or mouth breathing (SDB group) and matched controls.
- Polysomnography was performed on SDB group participants.
- Serum lipid profiles (TC, TG, HDL-C, LDL-C) were measured using enzymatic assays.
Main Results:
- Children with OSAS showed significantly higher TC, TG, LDL-C, and LDL/HDL ratios compared to PS and control groups.
- The PS group also exhibited higher lipid levels than the control group.
- Serum triglycerides correlated negatively with lowest oxygen saturation and positively with BMI-z score; obese children had higher TG levels.
Conclusions:
- SDB significantly affects blood lipid profiles in children, even in cases of PS without significant apnea or hypoxia.
- Obesity is specifically associated with elevated triglyceride levels in children with SDB.
Background:
Sleep-disordered breathing (SDB) during childhood is common and includes a range of breathing abnormalities that range from primary snoring (PS) to obstructive sleep apnea syndrome (OSAS).Studies have shown that not only OSAS, but also PS, which is originally considered harmless, could cause cardiovascular, cognitive, behavioral, and psychosocial problems. Many researches are focused on the relation of OSA and serum lipid levels. However, little studies are focused on PS and serum lipid levels in children.We evaluated whether serum lipid (total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C)) concentrations were associated with specific components of SDB, including indices of oxygen reduction index, lowest oxygen saturation, mean oxygen saturation. And we explored whether serum lipid levels were associated with different degree sleep disordered (PS and OSA group) and obese.
Methods:
This was a cross-sectional study. Children who were complained by their guardians with habitual snoring and(or) mouth breathing were collected in the SDB group. Normal children without sleep problem were matched in the control group. Subjects in the SDB group underwent polysomnography. The serum lipid profiles of all the children included TC, TG, HDL-C and LDL-C concentrations were measured by appropriate enzymatic assays.
Results:
A total of 241 with Apnea/Hypopnea Index ≥ 5 (AHI) were assigned to the OSAS group and the remaining 155 with normal AHI were assigned to the PS group. The values of TC, TG, LDL-C and LDL/HDL were significantly higher in the OSAS group than in the PS group, and the values in the PS group were significantly higher than the control group. Multiple regression analysis revealed serum TG only correlated negatively with lowest oxygen saturation. Body mass index-z score has a positive effect on TG in all the 1310 children (P = 0.031) and in SDB 396 children(P = 0.012). The level of serum TG in obese group was significantly higher than that in non-obese group.
Conclusions:
SDB had a very obvious effect on blood lipids, whereas PS without apnea and hypoxia. Obese only affects the aggregation of TG.
Trial Registration:
ChiCTR1900026807(2019.10.23).
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