Impact of obstructive sleep apnoea on insulin resistance in nonobese and obese children
| Autor: | Rakesh Bhattacharjee, David Gozal, Dorit Koren, Mona F. Philby, Leila Kheirandish-Gozal |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Blood Glucose
Male Pulmonary and Respiratory Medicine Pediatric Obesity medicine.medical_specialty Lipoproteins Polysomnography medicine.medical_treatment Sleep REM Context (language use) 03 medical and health sciences 0302 clinical medicine Insulin resistance Internal medicine Odds Ratio medicine Humans Prospective Studies 030212 general & internal medicine Child Sleep Apnea Obstructive Sleep disorder Anthropometry medicine.diagnostic_test business.industry Insulin Snoring Sleep apnea medicine.disease Obesity respiratory tract diseases Endocrinology 030228 respiratory system Child Preschool Multivariate Analysis Female Insulin Resistance Metabolic syndrome business |
| Zdroj: | European Respiratory Journal. 47:1152-1161 |
| ISSN: | 1399-3003 0903-1936 |
| Popis: | Obstructive sleep apnoea (OSA) has been inconsistently associated with insulin resistance and adverse metabolic states. We aimed to assess independent contributions of OSA to insulin resistance and dyslipidaemia in a large paediatric cohort.Habitually snoring children underwent overnight polysomnography, anthropometric measurements and fasting laboratory evaluations. Primary outcome measures included insulin, glucose, homeostasis model of insulin resistance, lipoproteins and sleep disturbance measures.Among 459 children aged 5–12 years, obesity was the primary driver of most associations between OSA and metabolic measures, but sleep duration was inversely associated with glucose levels, with N3 and rapid eye movement (REM) sleep being negatively associated and sleep fragmentation positively associated with insulin resistance measures. In children with mild OSA, the presence of obesity increased the odds for insulin resistance, while higher apnoea/hypopnoea index values emerged among obese children who were more insulin-resistant.The exclusive presence of interactions between OSA and obesity in the degree of insulin resistance is coupled with synergistic contributions by sleep fragmentation to insulin resistance in the context of obesity. Insufficient N3 or REM sleep may also contribute to higher glycaemia independently of obesity. Studies are needed to better delineate the roles of puberty and sleep fragmentation in insulin resistance and the metabolic syndrome. |
| Databáze: | OpenAIRE |
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