Obstructive sleep apnea and metabolic disorders in morbidly obese adolescents

Haim, Alon; Daniel, Sharon; Hershkovitz, Eli; Goldbart, Aviv; Tarasiuk, Ariel

doi:10.1002/ppul.25652

Cited by 6 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As shown by Redline et al, 15 OB is a strong risk factor for adult OSA, and is also a major risk factor for snoring or OSA in pediatric populations 35,44,45 . Accordingly, as illustrated in Table 2, we found significant differences between the OB prevalence of children with resolved OSA after treatment and those with persistent disease.…”

Section: Discussionsupporting

confidence: 67%

“…27 Finally, there is also relevance in evaluating the association between OB, OSA, and MetS. 15,19,30,35 Therefore, children with body mass index (BMI) z-score values exceeding the 95th percentile were classified as fulfilling the criteria for OB, following the recommendations of the Centers for Disease Control and Prevention (https:// www.cdc.gov/obesity/basics/childhood-defining.html).…”

Section: Definition Of Metsmentioning

confidence: 99%

See 1 more Smart Citation

Persistent sleep‐disordered breathing independently contributes to metabolic syndrome in prepubertal children

Armañac‐Julián,

Martín‐Montero,

Lázaro

et al. 2023

Pediatric Pulmonology

View full text Add to dashboard Cite

BackgroundObstructive sleep apnea (OSA) is a risk factor for metabolic syndrome (MetS) in adults, but its association in prepubertal children is still questionable due to the relatively limited cardiometabolic data available and the phenotypic heterogeneity.ObjectiveTo identify the role of OSA as a potential mediator of MetS in prepubertal children.MethodsA total of 255 prepubertal children from the Childhood Adenotonsillectomy Trial were included, with standardized measurements taken before OSA treatment and 7 months later. MetS was defined if three or more of the following criteria were present: adiposity, high blood pressure, elevated glycemia, and dyslipidemia. A causal mediation analysis was conducted to assess the effect of OSA treatment on MetS.ResultsOSA treatment significantly impacted MetS, with the apnea–hypopnea index emerging as mediator (p = .02). This mediation role was not detected for any of the individual risk factors that define MetS. We further found that the relationship between MetS and OSA is ascribable to respiratory disturbance caused by the apnea episodes, while systemic inflammation as measured by C‐reactive protein, is mediated by desaturation events and fragmented sleep. In terms of evolution, patients with MetS were significantly more likely to recover after OSA treatment (odds ratio = 2.56, 95% confidence interval [CI] 1.20–5.46; risk ratio = 2.06, 95% CI 1.19–3.54) than the opposite, patients without MetS to develop it.ConclusionThe findings point to a causal role of OSA in the development of metabolic dysfunction, suggesting that persistent OSA may increase the risk of MetS in prepubertal children. This mediation role implies a need for developing screening for MetS in children presenting OSA symptoms.

show abstract

Section: Discussionsupporting

confidence: 67%

Section: Definition Of Metsmentioning

confidence: 99%

Persistent sleep‐disordered breathing independently contributes to metabolic syndrome in prepubertal children

Armañac‐Julián,

Martín‐Montero,

Lázaro

et al. 2023

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…The results from multivariate linear regression showed that BMI, the width of the nasal base, and SNA seemed to have significant influences on the severity of OSA. The impacts of obesity on development and severity of OSA have been well-known [ 50 , 51 ]. Maxillary protraction may lead to increased nasopharyngeal and upper oropharyngeal dimensions and an improvement in sleep apnea [ 13 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Obstructive sleep apnea and anatomical structures of the nasomaxillary complex in adolescents

2022

View full text Add to dashboard Cite

The aim of the present study was to reveal the associations between skeletal and soft tissue features of the nasomaxillary complex and development and severity of obstructive sleep apnea (OSA) in adolescents. A total of 100 adolescents (mean age, 14.9 ± 1.4 years; age range, 13–17 years) were enrolled. All participants underwent full-night polysomnography and had an assessment of size and position of the tongue, tonsillar size, body mass index (BMI), and circumference of the waist, neck, and hip. The skeletal features of the nasomaxillary complex, including the zygomatic arch width, nasal cavity width, nasal base width, intercanine width, intermolar width, maxillary dental arch length, palatal vault angle, palatal depth, and SNA were measured on the three-dimensional images constructed with computed tomography data. Participants with an apnea and hypopnea index (AHI) of lower than 5 (AHI ≤ 5) were classified as control and participants while those with an AHI of greater than 5 were classified as OSA group. Each variable with a significant outcome in the independent T-test and age and sex factors were integrated into the multivariate linear regression and the dependent variable was AHI. There were significant differences in the BMI and hip circumference between two groups. The width of nasal base, palatal vault angle and SNA also showed significant differences between groups. The results from multivariate linear regression demonstrated that the BMI, width of the nasal base, and SNA showed significant contributions to the severity of OSA in adolescents. The features of the nasomaxillary complex seemed to have significant influences on development and severity of OSA.

show abstract

“…Similar to obesity, the important perturbations of iron metabolism may be linked to the progression of OSA. There are many studies on iron metabolism and OSA [ 12 , 13 , 14 , 15 ], but only limited studies focus on body iron transport as reflected by serum TF levels and the results are controversial. Baik et al [ 16 ] indicated that OSA cases showed lower serum TF saturation levels than those without OSA no matter with male-pattern baldness or not.…”

Section: Introductionmentioning

confidence: 99%

Serum Transferrin Level Is Associated with the Severity of Obstructive Sleep Apnea Independently of Obesity: A Propensity Score-Match Observational Study

Ming

Yang

et al. 2022

Obes Facts

View full text Add to dashboard Cite

Introduction: Dysregulation of iron metabolism is closely associated with the development of obesity and obstructive sleep apnea (OSA), but little is known about the relationship between serum transferrin (TF) level and OSA severity. We aimed to verify this relationship and fit into account for obesity related confounders among bariatric candidates. Methods: We compared data retrospectively collected in 270 bariatric candidates. A propensity score-matched (PSM) analysis was used to determine the impact of iron metabolism on OSA severity independently of obesity. Univariate analysis was used to evaluate the relationship between serum TF level and the severity of OSA reflected by hypoxia and night awakenings parameters. Serum TF level to predict the severity of OSA was assessed by using univariate and multiple logistic regression model. Results: The preliminary analysis showed that serum ferritin (SF) [113 ng/ml (50-203) vs 79 ng/ml (40-130), p=0.009] and TF [2.72 g/L (2.46-3.09) vs 2.65 g/L (2.34-2.93), p=0.039] level was significantly higher in moderate/severe OSA group than no/mild OSA group. After PSM, there were 75 patients in each group and only serum TF level remained significant difference (p=0.014). The proportion of patients with combined T2D and hyperlipidemia also remained higher in moderate/severe OSA groups. Univariate analysis showed that the group with higher degree of hypoxia had higher serum TF levels [2.55 g/L (2.22-2.84) vs 2.79 g/L (2.56-3.06), p＜0.001]. Univariate and multiple logistic regression analysis showed that serum TF level emerged as a significant and independent factor associated with OSA severity especially grouped by oxygen desaturation index (ODI) (odds ratio: 2.91, 95% CI: 1.36-6.23, p = 0.006). Discussion/Conclusions: The existence of obstructive sleep apnea exacerbates obesity comorbidities, particularly type 2 diabetes and hyperlipidemia. Serum transferrin level is associated with the severity of OSA independently of obesity and might be a potential identification and therapeutic targets.

show abstract

Obstructive sleep apnea and metabolic disorders in morbidly obese adolescents

Cited by 6 publications

References 26 publications

Persistent sleep‐disordered breathing independently contributes to metabolic syndrome in prepubertal children

Persistent sleep‐disordered breathing independently contributes to metabolic syndrome in prepubertal children

Obstructive sleep apnea and anatomical structures of the nasomaxillary complex in adolescents

Serum Transferrin Level Is Associated with the Severity of Obstructive Sleep Apnea Independently of Obesity: A Propensity Score-Match Observational Study

Contact Info

Product

Resources

About