Sleep-disordered breathing in obese children is associated with prevalent excessive daytime sleepiness, inflammation, and metabolic abnormalities - PubMed (original) (raw)

Sleep-disordered breathing in obese children is associated with prevalent excessive daytime sleepiness, inflammation, and metabolic abnormalities

Marina Tsaoussoglou et al. J Clin Endocrinol Metab. 2010 Jan.

Abstract

Background: In obese adults, sleep apnea is associated with excessive daytime sleepiness (EDS) and cardiometabolic risk factors. In children, on the other hand, sleep-disordered breathing (SDB) is primarily associated with anatomic abnormalities and neurocognitive impairment, whereas studies on potential concurrent metabolic aberrations and EDS have been limited and inconsistent. In this study, we examined the joint effect of SDB and obesity in EDS as well as proinflammatory and metabolic markers.

Methods: One hundred fifty children, aged 5-17 yr, were consecutively recruited from our sleep disorders clinic and a subset of the Penn State Children's Cohort. Every child had a thorough history and physical examination, 9-h polysomnographic study, and a single blood draw for the assessment of IL-6, TNFalpha, soluble IL-6 receptor, TNF receptor-1, hypersensitive C-reactive protein, leptin, and adiponectin. In addition, parents completed a subjective questionnaire to assess EDS. Analysis of covariance was performed on four groups that were separated by SDB severity and body mass index.

Results: EDS frequency increased progressively and significantly in the four groups. There was a significant linear trend in plasma IL-6, TNF receptor-1, hypersensitive C-reactive protein, and leptin concentrations, with lowest levels observed in lean controls and highest in overweight/obese with moderate SDB. Adiponectin followed the opposite pattern.

Conclusions: This study suggests that in a clinical sample of obese children, SDB is associated with EDS, elevation of proinflammatory cytokines, increased leptin, and decreased adiponectin. All these changes point to an inflammatory/insulin resistance state, suggesting that SDB in obese children share many similarities with SDB in obese adults.

PubMed Disclaimer

Figures

Figure 1

Percentage of EDS in lean controls, overweight/obese controls, overweight/obese with mild SDB, and overweight/obese with moderate SDB (P = 0.001).

Figure 2

Plasma levels of IL-6 (A) and hsCRP (B) in lean controls, overweight/obese controls, overweight/obese with mild SDB, and overweight/obese with moderate SDB (P = 0.012, P < 0.001, respectively).

Figure 3

Plasma levels of leptin (A) and adiponectin (B) in lean controls, overweight/obese controls, overweight/obese with mild SDB, and overweight/obese with moderate SDB (P < 0.001, P = 0.005, respectively).

References

1. Lumeng JC, Chervin RD 2008 Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc 5:242–252 - PMC - PubMed
1. Bixler EO, Vgontzas AN, Lin HM, Liao D, Calhoun S, Fedok F, Vlasic V, Graff G 2008 Blood pressure associated with sleep-disordered breathing in a population sample of children. Hypertension 52:841–846 - PMC - PubMed
1. Ogden CL, Carroll MD, Flegal KM 2008 High body mass index for age among US children and adolescents, 2003–2006. JAMA 299:2401–2405 - PubMed
1. Vgontzas AN, Bixler EO, Tan TL, Kantner D, Martin LF, Kales A 1998 Obesity without sleep apnea is associated with daytime sleepiness. Arch Intern Med 158:1333–1337 - PubMed
1. Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela-Bueno A, Kales A 2005 Excessive daytime sleepiness in a general population sample: the role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab 90:4510–4515 - PubMed

Sleep-disordered breathing in obese children is associated with prevalent excessive daytime sleepiness, inflammation, and metabolic abnormalities - PubMed (original) (raw)