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Obstructive sleep apnea is associated with impaired insulin clearance and hepatic insulin sensitivity in paediatric

Giuseppina Rosaria Umano1, Francesca Aiello1, Giulia Rondinelli1

  • 1Department of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.

Diabetes, Obesity & Metabolism
|May 14, 2025
PubMed

Insights

Moderate-to-severe obstructive sleep apnea (OSA) in obese children impairs insulin clearance and hepatic insulin sensitivity, potentially explaining hyperinsulinism. This finding highlights a critical link between sleep health and metabolic dysfunction in pediatric obesity.

Area of Science:

  • Pediatric Endocrinology
  • Sleep Medicine
  • Metabolic Disorders

Background:

  • Obstructive sleep apnea (OSA) affects a significant portion of children and adolescents with obesity.
  • OSA is associated with hyperinsulinism, but the underlying mechanisms are not fully understood.
  • Understanding these mechanisms is crucial for managing metabolic complications in pediatric obesity.

Purpose of the Study:

  • To investigate the determinants of hyperinsulinemia in pediatric patients with OSA.
  • To assess insulin clearance, insulin secretion, and insulin sensitivity in children with varying degrees of OSA.
  • To elucidate the relationship between OSA severity and metabolic parameters.

Main Methods:

  • Seventy children with obesity and suspected OSA underwent polysomnography and a 3-hour oral glucose tolerance test (OGTT).
  • Insulin secretion rate (ISR) was calculated using C-peptide deconvolution; insulin clearance and whole-body insulin sensitivity (Matsuda Index) were determined.
  • Hepatic insulin resistance index (HIRI) was calculated based on early glucose and insulin levels during OGTT.

Main Results:

  • Children with moderate-severe OSA exhibited reduced insulin clearance during OGTT and higher HIRI compared to those with mild OSA.
  • No significant differences in basal insulin clearance, ISR, or whole-body insulin sensitivity were observed between groups.
  • OSA severity correlated negatively with both fasting and OGTT insulin clearance and positively with HIRI.

Conclusions:

  • Moderate-to-severe OSA in obese children is linked to impaired insulin clearance and hepatic insulin sensitivity.
  • These metabolic alterations may contribute to the development of hyperinsulinism in pediatric OSA.
  • The findings underscore the importance of addressing OSA in managing metabolic health in obese children.
Abstract

Keywords:
insulin clearanceobesityobstructive sleep apnea

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