Published online July 1, 2005
PEDIATRICS Vol. 116 No. 1 July 2005, pp. e66-e73 (doi:10.1542/peds.2004-2527)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tauman, R.
Right arrow Articles by Gozal, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tauman, R.
Right arrow Articles by Gozal, D.
Related Collections
Right arrow Nutrition & Metabolism

ELECTRONIC ARTICLE

Obesity Rather Than Severity of Sleep-Disordered Breathing as the Major Determinant of Insulin Resistance and Altered Lipidemia in Snoring Children

Riva Tauman, MD, Louise M. O’Brien, PhD, Anna Ivanenko, MD, PhD and David Gozal, MD

From the Division of Pediatric Sleep Medicine and Kosair Children’s Hospital Research Institute, Department of Pediatrics, University of Louisville, Louisville, Kentucky

Objective. Sleep-disordered breathing (SDB) is associated with insulin resistance and dyslipidemia in adults and in obese children. However, the prevalence of such metabolic abnormalities among snoring children is unknown. This study was done to prospectively assess the relative contribution of SDB and obesity to metabolic disturbances in a large cohort of snoring children.

Methods. Measurements of fasting serum glucose, insulin, and lipids were obtained after polysomnographic evaluation in 116 snoring children and in 19 control subjects. Insulin resistance was assessed using the insulin/glucose ratio (I/G ratio) and homeostasis model assessment (HOMA).

Results. A total of 135 children (79 boys; mean age: 8.9 ± 3.5 years) were studied. Sixty-four children had moderate to severe SDB (AHI = 5 per hour of total sleep time [TST]), 52 had mild SDB (AHI = 1 but <5 per hour of TST), and 19 were control subjects (AHI <1 per hour of TST). Seventy of these children were obese. No significant correlations were found between AHI, lowest arterial oxygen saturation, or arousal index and serum insulin, serum glucose, I/G ratio, HOMA, or serum lipids for either the whole group or the obese children only. However, significant positive correlations were found between I/G ratio and relative BMI (relBMI; r = 0.58), HOMA and relBMI (r = 0.52), triglycerides and relBMI (r = 0.30), and high-density lipoprotein and relBMI (r = 0.50). No significant differences were found in relBMI, I/G ratio, and lipid levels between boys and girls.

Conclusions. Among children with suspected SDB, insulin resistance and dyslipidemia seem to be determined primarily by the degree of body adiposity rather than by the severity of SDB.

Key Words: metabolic syndrome • sleep apnea • pediatrics • obesity • diabetes

Abbreviations: SDB, sleep-disordered breathing • CPAP, continuous positive airway pressure • CRP, C-reactive protein • SpO2, arterial oxygen saturation • AHI, apnea hypopnea index • TST, total sleep time • relBMI, relative BMI • HOMA, homeostasis model assessment • I/G ratio, insulin/glucose ratio • HDL, high-density lipoprotein • TG, triglyceride

Accepted Jan 13, 2004.




This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
D. Gozal, O. S. Capdevila, and L. Kheirandish-Gozal
Metabolic Alterations and Systemic Inflammation in Obstructive Sleep Apnea among Nonobese and Obese Prepubertal Children
Am. J. Respir. Crit. Care Med., May 15, 2008; 177(10): 1142 - 1149.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
O. S. Capdevila, L. Kheirandish-Gozal, E. Dayyat, and D. Gozal
Pediatric Obstructive Sleep Apnea: Complications, Management, and Long-term Outcomes
Proceedings of the ATS, February 15, 2008; 5(2): 274 - 282.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
L. Kheirandish-Gozal, O. Sans Capdevila, E. Kheirandish, and D. Gozal
Elevated Serum Aminotransferase Levels in Children at Risk for Obstructive Sleep Apnea
Chest, January 1, 2008; 133(1): 92 - 99.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Redline, A. Storfer-Isser, C. L. Rosen, N. L. Johnson, H. L. Kirchner, J. Emancipator, and A. M. Kibler
Association between Metabolic Syndrome and Sleep-disordered Breathing in Adolescents
Am. J. Respir. Crit. Care Med., August 15, 2007; 176(4): 401 - 408.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
S. R. Coughlin, L. Mawdsley, J. A. Mugarza, J. P. H. Wilding, and P. M. A. Calverley
Cardiovascular and metabolic effects of CPAP in obese males with OSA
Eur. Respir. J., April 1, 2007; 29(4): 720 - 727.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
W. T. McNicholas, M. R. Bonsignore, and the Management Committee of EU COST ACTION B26
Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities
Eur. Respir. J., January 1, 2007; 29(1): 156 - 178.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
K. A. Waters, S. Sitha, L. M. O'Brien, S. Bibby, C. de Torres, S. Vella, and R. de la Eva
Follow-up on Metabolic Markers in Children Treated for Obstructive Sleep Apnea
Am. J. Respir. Crit. Care Med., August 15, 2006; 174(4): 455 - 460.
[Abstract] [Full Text] [PDF]