Original ArticlesMetabolic correlates with obstructive sleep apnea in obese subjects☆,☆☆
Section snippets
Patients and methods
Obese children with a history of snoring were eligible for the study. Obesity was defined as a body mass index (BMI; weight/height2) >95th percentile for age and sex reference values.20 Children were excluded from the study if they had an intercurrent respiratory tract infection, a neuromuscular disorder, or they were being treated with anticonvulsant or sedative medication. Children were recruited from a range of hospitals and private clinics, as well as primary referrals to the 2 major
Patient characteristics
Obese children (n = 62, 46 males) aged 5 years to 16 years (mean ± SD, 10.9 ± 3.2) were recruited (Table I).Empty Cell Mean ± SD Range Age (y) 10.89 ± 3.14 5-16 Males, n (%) 46 (74%) Weight (kg) 72.6 ± 29.4 26.5-150.0 Height (cm) 150.6 ± 19.7 104-200 Height (percentile) 74.6 ± 29.0 4-100 BMI (kg/m2) 31.2 ± 7.0 19.7-54.8 BMI (Z score) 3.5 ±1.9 1.7-11.8
Mean fasting insulin levels
Discussion
This study evaluated the association between OSA and insulin resistance in children; studies have shown similar perturbations in adult populations. We have demonstrated that the severity of OSA relates to fasting insulin levels in obese children. The severity of OSA was independently correlated with fasting insulin levels, after accounting for age and BMI. Stoohs et al10 showed that the association between insulin resistance and OSA was BMI-dependent in adults. The BMI range (15-39 kg/m2) shows
Acknowledgements
We thank the parents and children for their particpation in the study, Ms Kellie Tinworth for her assistance in preparation of the manuscript, and Assistant Professor Jennifer Peat for her advice on statistical analyses.
References (37)
The chronic disease of childhood obesity: the sleeping giant has awakened
J Pediatr
(2000)- et al.
Relationship between insulin resistance and abnormal lipid profile in obese adolescents
J Pediatr
(1995) - et al.
Pituitary reactivity, androgens, and catecholamines in obstructive sleep apnoea: effects of continuous positive airway pressure treatment (CPAP)
Respir Med
(1999) - et al.
High incidence of sleep apnea syndrome in a male diabetic population
Diabetes Res Clin Pract
(1991) - et al.
Interpretation of Z score anthropometric indicators derived from the international growth reference
Am J Clin Nutr
(1987) - et al.
Sleep-related breathing disorders in adolescents aged 12 to 16 years: clinical and polygraphic findings
Chest
(2001) - et al.
Sleep-associated breathing disorders in morbidly obese children and adolescents
J Pediatr
(1989) - et al.
Correlation between the glucose clamp technique and the homeostasis model assessment in hypertension
Am J Hypertens
(2001) - et al.
Change in body mass index in Australian primary school children, 1985-1997
Int J Obes Relat Metab Disord
(2000) - et al.
Overweight prevalence and trends for children and adolescents: the National Health and Nutrition Examination Surveys, 1963 to 1991
Arch Pediatr Adolesc Med
(1995)
Persistent elevation of plasma insulin levels is associated with increased cardiovascular risk in children and young adults: the Bogalusa Heart Study
Circulation
Risks and consequences of childhood and adolescent obesity
Int J Obes Relat Metab Disord
Role of insulin resistance in human disease (syndrome X): an expanded definition
Annu Rev Med
Hyperinsulinaemia: the key feature of a cardiovascular and metabolic syndrome
Diabetologia
The role of insulin in clustering of serum lipids and blood pressure in children and adolescents: the Cardiovascular Risk in Young Finns Study
Diabetologia
Insulin resistance and sleepdisordered breathing in healthy humans
Am J Respir Crit Care Med
Impact of obstructive sleep apnea and sleepiness on metabolic and cardiovascular risk factors in the Swedish Obese Subjects (SOS) Study
Int J Obes Relat Metab Disord
Hypertension and associated metabolic abnormalities: the role of insulin resistance and the sympathoadrenal system
N Engl J Med
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Supported by the Children's Hospital Fund and by an Astra Australian Lung Foundation Career Development Award (to K. A. W.).
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Reprint requests: Karen A. Waters, MD, Dept of Respiratory Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia.