Obesity in children with different risk factors for obstructive sleep apnea: a community-based study

Background: Sleep-related breathing disorders (SRBD) have been identified as a major public health problem closely related to adolescent obesity. We aimed to estimate the prevalences of SRBD and snoring in adolescents in Changchun City, Northeastern China, and to evaluate the associated factors in this population. Methods: In total, 1955 adolescents aged 11–18 years were recruited in Changchun City using stratified cluster sampling. Parents and caretakers of children completed the questionnaires, which included demographic characteristics, anthropometric parameters and a pediatric sleep questionnaire (SRBD scale). Logistic regression was used to analyze the relationship between SRBD, snoring and other factors. Results: The prevalences of SRBD and snoring in our population were 3.7% and 3.3%, respectively, and the prevalences of overweight and obesity were 12.6% and 4.9%. Multivariate logistic regression showed that urban residence (OR = 2.356, 95%CI: 1.251–4.435) and post-term birth (OR = 3.275, 95%CI: 1.396–7.683) were significantly associated with SRBD. Preterm birth (OR = 2.255, 95%CI: 1.021–4.980) and parental education level of university and above (OR = 0.265, 95%CI: 0.083–0.850) were significantly associated with snoring. Overweight (OR = 2.063, 95%CI: 1.062–4.006) was also related to snoring. Conclusions: The prevalences of SRBD and snoring were similar to those reported in previous studies. Urban residence and post-term birth were important influencing factors for SRBD; overweight, highest parental education level (university and above) and preterm birth were key factors affecting snoring in adolescents.

Section: Discussionmentioning

confidence: 99%

Associations of Overweight, Obesity and Related Factors with Sleep-Related Breathing Disorders and Snoring in Adolescents: A Cross-Sectional Survey

Peng

Kou

et al. 2017

IJERPH

“…Obesity seems to play a role too, however, no sufficient evidence has been reported to support a strong effect in children as being reported in adults [6][7][8]. Considering the lack of solid links between weight status, lymphoid tissue size, and OSA severity in pediatric patients, other pathophysiological mechanisms have been postulated [9,10], either alone or in combination with obesity.…”

Section: Introductionmentioning

confidence: 99%

Relationships Among and Predictive Values of Obesity, Inflammation Markers, and Disease Severity in Pediatric Patients with Obstructive Sleep Apnea Before and After Adenotonsillectomy

Huang

et al. 2020

JCM

Both obstructive sleep apnea (OSA) and obesity are major health issues that contribute to increased systemic inflammation in children. To date, adenotonsillectomy (AT) is still the first-line treatment for childhood OSA. However, the relationships among and predictive values of obesity, inflammation, and OSA severity have not been comprehensively investigated. This prospective study investigated body mass index (BMI), serum inflammatory markers, and OSA severity before and after AT in 60 pediatric patients with OSA. At baseline, differences in levels of interleukin-6, interleukin-9, basic fibroblast growth factor, platelet-derived growth factor-BB, as well as regulated on activation, normal T cell expressed and secreted (RANTES) were significant among the various weight status and OSA severity subgroups. After 3 months postoperatively, the differences in these inflammatory markers diminished along with a decrease in OSA severity while obesity persisted. The rate of surgical cure (defined as postoperative obstructive apnea-hypopnea index < 2.0 and obstructive apnea index < 1.0) was 62%. Multivariate analysis revealed that age, BMI z-score, granulocyte-macrophage colony-stimulating factor, monocyte chemotactic protein-1, and RANTES independently predicted surgical cure. Despite the significant reductions in inflammatory markers and OSA severity after AT, an inter-dependent relationship between obesity and OSA persisted. In addition to age and BMI, several inflammatory markers helped to precisely predict surgical cure.

“…While there is a growing volume of studies on the further phenotyping and clustering of adult OSA patients, a similar effort for children with OSA is still relatively rare. Obesity and adenotonsillar hypertrophy are well documented risk factors for pediatric OSA [ 5 , 11 , 12 ]; however, only a few studies have focused on patient subgroups based on characteristics such as age, sex, and symptoms or elucidated the heterogeneity in their pathogeneses and treatment options [ 13 , 14 , 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Kang et al demonstrated that the influence of adenoid size on pediatric OSA decreased in adolescents [ 13 ]. However, Su and colleagues reported differential risk factors for preschool and school-age children [ 14 ]. In addition, Brockmann proposed that gender bias may exist in the screening and diagnosis of pediatric OSA and suggested that further investigations on gender-specific pathophysiological mechanisms are necessary [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Differences in Anthropometric and Clinical Features among Preschoolers, School-Age Children, and Adolescents with Obstructive Sleep Apnea—A Hospital-Based Study in Taiwan

Hsu

et al. 2020

IJERPH

Pediatric obstructive sleep apnea (OSA) is associated with adverse health outcomes; however, little is known about the diversity of this population. This retrospective study aims to investigate age-related differences in the anthropometric and clinical features of this population. A total of 253 Taiwanese children (70 (27.7%) girls and 183 (72.3%) boys) with OSA were reviewed. Their median age, body mass index (BMI) z-score, and apnea-hypopnea index were 6.9 years, 0.87, and 9.5 events/h, respectively. The cohort was divided into three subgroups: ‘preschoolers’ (≥2 and <6 years), ‘school-age children’ (≥6 and <10 years), and ‘adolescents (≥10 and <18 years)’. The percentage of the male sex, BMI z-score, neck circumference, systolic blood pressure z-score, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio tended to increase with age. Adenoid grades tended to decrease with age. Overall, disease severity was independently correlated with neck circumference, tonsil size, and adenoid grade. Increased neck circumference and tonsillar hypertrophy were the most influential factors for younger children, whereas adenoidal hypertrophy became more important at an older age. In conclusion, gender prevalence ratio, anthropometric measures, and clinical features varied with age, and the pathogenic drivers were not necessarily the same as the aggravating ones.