Is sleep-disordered breathing an additional risk factor for the metabolic syndrome in obese children and adolescents?

Verhulst, Stijn; Rooman, Raoul; Gaal, Luc Van; Backer, Wilfried De; Desager, Kristine

doi:10.1038/ijo.2008.152

Cited by 32 publications

(17 citation statements)

References 41 publications

(46 reference statements)

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“…Observational studies further reported that CPAP compliance determined a positive outcome in HOMA-IR [15], or a decrease in glycosylated haemoglobin but not HOMA-IR [17]. Data on changes in fasting insulin or HOMA-IR in children before and after adenotonsillectomy were similarly variable [27,28]. In diabetic subjects with OSA, despite several positive observational studies [6,8,11,12], a randomised controlled study reported that neither HbA 1C nor insulin sensitivity measured by the euglycemic clamp changed [14].…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of nasal continuous positive airway pressure on insulin sensitivity in obstructive sleep apnoea

Lam¹,

Lam²,

Yao³

et al. 2009

European Respiratory Journal

152

128

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The effects of treatment of obstructive sleep apnoea (OSA) on glucose metabolism have been investigated previously with conflicting results. This study evaluated the impact of nasal continuous positive airway pressure (nCPAP) treatment of OSA on insulin sensitivity.Males with moderate/severe OSA and no significant comorbidity were randomised to a therapeutic or sham nCPAP treatment group for 1 week and then reassessed. Those who received therapeutic nCPAP were further evaluated at 12 weeks. Insulin sensitivity (Kitt) was estimated by the short insulin tolerance test. Other evaluations included blood pressure, metabolic profile, urinary catecholamines and intra-abdominal fat.In total, 61 Chinese subjects were randomised. 31 subjects receiving therapeutic nCPAP showed an increase in Kitt (6.6¡2.9 to 7.6¡3.2 %?min -1 ; p50.017), while the 30 patients on sham CPAP had no significant change, and the changes in Kitt were different between the two groups (p50.022). At 12 weeks, improvement in Kitt was seen in 20 subjects with BMI o25 kg?m -2(median (interquartile range) 28.3 (26.6-31.5); p50.044), but not in the nine subjects with BMI,25 kg?m -2 , or the entire group.The findings indicate that therapeutic nCPAP treatment of OSA for 1 week improved insulin sensitivity in nondiabetic males, and the improvement appeared to be maintained after 12 weeks of treatment in those with moderate obesity.

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Section: Discussionmentioning

confidence: 99%

A randomised controlled trial of nasal continuous positive airway pressure on insulin sensitivity in obstructive sleep apnoea

Lam¹,

Lam²,

Yao³

et al. 2009

European Respiratory Journal

152

128

View full text Add to dashboard Cite

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“…Leptin and ghrelin, hormones involved in controlling satiation and hunger, are also linked to sleep. Therefore, partial chronic sleep loss can increase food consumption and apathy towards physical activity 20 . Recently, a study 21 conducted in Alhambra, California involving 356 fifth-grade students from six public and private schools revealed a significant association between sleep onset latency and emotional eating (p=0.30), depressive symptoms (p<0.0001), and anxiety traits (p>0.0001).…”

Section: Discussionmentioning

confidence: 99%

Quality of life and sleep in obese adolescents

Turco

Bobbio

Reimão³

et al. 2013

Arq. Neuro-Psiquiatr.

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Obesity is defined as excess body fat versus lean mass, and it is classified as a chronic noncommunicable disease. This condition is associated with a broad array of complications, including cardiovascular, endocrine-metabolic, and orthopedic issues as well as breathing, sleep, and psychological disorders, among others 1 . Psychosocial disorders related to obesity include anxiety, depression, anguish, low self-esteem, guilt feelings, social adjustment problems, and behavioral/conduct disorders. These disorders can constitute the cause or effect of the weight gain process and negatively impact on quality of life (QL) 2,3 .Studies have found that lack of physical activity, poor diet, high consumption of processed foods, low intake of fruit, vegetables and legumes as well as frequent computer, videogame and television use, are strongly associated with the development of obesity and reduced total sleep time 4,5 . An important theme underpinning these investigations centers on the relationship between sleep disorders and cultural and familial ABSTRACTObesity and sleep disorders in adolescence are strongly associated, and they impact both on the health and on quality of life (QL) in this age group. Objective: To comparatively assess QL and sleep in obese and eutrophic adolescents, who are older than ten years of age. Methods: Cross-sectional study including obese adolescents. This analysis was carried out between August 2009 and August 2010. The Control (eutrophic) Group comprised schoolchildren recruited from State schools in the city of Americana, in São Paulo State, Brazil. Instruments applied included a standardized questionnaire, the Sleep Behavior Questionnaire (SBQ), and the Pediatric QL Inventory (PedsQL TM 4.0). Results: The obese adolescents had poorer QL on physical (p<0.001), emotional (p=0.03), and social (p=0.002) functioning domains. A difference in mean psychosocial functioning was found between the groups (p=0.009) with obese subjects having a mean score of 69.5 (±16.0) and in eutrophic individuals of 76.2 (±16.7). A greater number of sleep problems was evident in the Obese Group (p=0.03). Conclusions: The obese adolescents had an impaired QL and a higher frequency of sleep problems compared to the eutrophic subjects.Key words: sleep, adolescents, obesity, quality of life. RESUMOObesidade e distúrbios do sono na adolescência estão amplamente associados, afetando a saúde e a qualidade de vida (QV) de tal grupo etário. Objetivo: Foi avaliar comparando a QV e o sono em adolescentes obesos e eutróficos maiores de dez anos. Métodos: Estudo transversal realizado entre agosto de 2009 e agosto de 2010, com adolescentes obesos. O Grupo Controle (eutróficos) foi constituído por estudantes da rede pública de ensino da cidade de Americana, em São Paulo. Foram utilizados ficha de identificação, Questionário do Comportamento do Sono (SBQ), Questionário de QV (PedsQL TM 4.0) como instrumentos. Resultados: Os adolescentes obesos apresentaram QV inferior à dos controles nos domínios físico (p<0,001), emocional (p=0,0...

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“…In addition, children classically represent a good clinical model for examining the relationship between SDB and glucose metabolism with limited coexistent comorbidity, even though differences between adult and paediatric OSA may have become smaller due to the current high prevalence of obesity at a young age [129]. The causal role of SDB in paediatric metabolic abnormalities is currently unclear, as indicated in a recent review [130].…”

Section: Effects Of Osa Treatmentmentioning

confidence: 99%

Sleep, sleep-disordered breathing and metabolic consequences

Lévy¹,

Bonsignore²,

Eckel³

2009

European Respiratory Journal

292

187

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Sleep profoundly affects metabolic pathways. In healthy subjects, experimental sleep restriction caused insulin resistance (IR) and increased evening cortisol and sympathetic activation. Increased obesity in subjects reporting short sleep duration leads to speculation that, during recent decades, decreased sleeping time in the general population may have contributed to the increasing prevalence of obesity. Causal inference is difficult due to lack of control for confounders and inconsistent evidence of temporal sequence.In the general population, obstructive sleep apnoea (OSA) is associated with glucose intolerance. OSA severity is also associated with the degree of IR. However, OSA at baseline does not seem to significantly predict the development of diabetes. Prevalence of the metabolic syndrome is higher in patients with OSA than in obese subjects without OSA. Treatment with continuous positive airway pressure seems to improve glucose metabolism both in diabetic and nondiabetic OSA but mainly in nonobese subjects.The relative role of obesity and OSA in the pathogenesis of metabolic alterations is still unclear and is intensively studied in clinical and experimental models. In the intermittent hypoxia model in rodents, strong interactions are likely to occur between haemodynamic alterations, systemic inflammation and metabolic changes, modulated by genetic background. Molecular and cellular mechanisms are currently being investigated.

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Is sleep-disordered breathing an additional risk factor for the metabolic syndrome in obese children and adolescents?

Cited by 32 publications

References 41 publications

A randomised controlled trial of nasal continuous positive airway pressure on insulin sensitivity in obstructive sleep apnoea

A randomised controlled trial of nasal continuous positive airway pressure on insulin sensitivity in obstructive sleep apnoea

Quality of life and sleep in obese adolescents

Sleep, sleep-disordered breathing and metabolic consequences

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