Overweight and obese children with sleep disordered breathing have elevated arterial stiffness

Walter, Lisa M.; Tamanyan, Knarik; Limawan, Albert Prabowo; Biggs, Sarah Nichole; Weichard, Aidan; Davey, Margot J; Nixon, Gillian M.; Horne, Rosemary Sylvia Claire

doi:10.1016/j.sleep.2018.05.007

Cited by 11 publications

(7 citation statements)

References 46 publications

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“…11,21 It has been theorized that OSA has a causal relationship with HTN because of association with increased arterial stiffness and sympathetic tone. [25][26][27] Furthermore, several studies in pediatric patients have demonstrated that adequate treatment of OSA (eg, via nighttime CPAP/BiPAP or curative tonsillectomy and adenoidectomy) can lead to improvements in BP 3,4 as well as other cardiovascular complications in adults (eg, right-heart parameters, risk of myocardial infarction, or stroke). 1,2 In addition, appropriate treatment of HTN/EBP can lead to the improvement of OSA severity.…”

Section: Discussionmentioning

confidence: 99%

The relationship of hypertension with obesity and obstructive sleep apnea in adolescents

Khan

Mathur

Barraza

et al. 2020

Pediatric Pulmonology

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Objectives To assess the independent relationships of obesity and obstructive sleep apnea (OSA) with hypertension/elevated blood pressure (EBP) in adolescent patients. Study Design A retrospective cohort analysis was performed on 501 patients (age 13‐21 years) with three separate blood pressure measurements within 6 months of polysomnography. EBP was defined as average systolic blood pressure (SBP) ≤120 mm Hg; obesity as body mass index Z‐score ≤1.65; and OSA as obstructive apnea‐hypopnea index <1. Pearson correlations and multivariable analyses were performed to assess the independent effects of the apnea‐hypopnea index and body mass index Z‐score on SBP. Results Of 501 patients (mean age 16 ± 2 years), 246 (49%) were male. OSA was present in 329 (66%) patients, obesity in 337 (67%), and EBP in 262 (52%). EBP was present in 70% of obese adolescents and 60% of adolescents with OSA. Univariable correlation showed a significant relationship between SBP, body mass index Z‐score, and apnea‐hypopnea index. Multivariable linear regression analysis showed blood pressure was significantly associated with body mass index Z‐score (β = .46; P < .01), age (β = .25; P < .01), and height Z‐score (β = .14; P < .01), but not apnea‐hypopnea index (β = .01; P = .72). Conclusions The relationship between OSA and EBP in adolescents is most closely associated with the degree of obesity. Further studies are needed to assess the effect of the treatment of obesity and OSA on blood pressure in adolescents.

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Section: Discussionmentioning

confidence: 99%

The relationship of hypertension with obesity and obstructive sleep apnea in adolescents

Khan

Mathur

Barraza

et al. 2020

Pediatric Pulmonology

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“…Thus, obesity is one of the most important risk factors for significant disease severity among children with OSAS [ 19 ], and those who have both conditions are at a greater risk of adverse outcomes of various organ systems. For example, Walter et al reported that overweight/obese children with OSAS were more likely to have arterial stiffness than normal-weight children with OSAS and non-snoring controls [ 20 ]. Obesity has also been associated with exercise deconditioning in children with OSAS [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

Chuang

Hsu

Wang

et al. 2021

IJERPH

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Older age, obesity, and obstructive sleep apnea syndrome (OSAS) are known to increase the risk of hypertension in adults. However, data for children are scarce. This study aimed to investigate the relationships between hypertension, age, weight status, and disease severity in 396 children with OSAS. The prevalence rates of hypertension, obesity, and severe OSAS (apnea-hypopnea index ≥10) were 27.0%, 28.0%, and 42.9%, respectively. Weight z-score and apnea-hypopnea index were independently correlated with systolic blood pressure z-score, and minimal blood oxygen saturation (SpO2) was independently associated with diastolic blood pressure z-score. Overall, late childhood/adolescence (odds ratio (OR) = 1.72, 95% CI = 1.05–2.81), obesity (OR, 2.58, 95% CI = 1.58–4.22), and severe OSAS (OR = 2.38, 95% CI = 1.48–3.81) were independent predictors of pediatric hypertension. Furthermore, late childhood/adolescence (OR = 2.50, 95% CI = 1.10–5.71) and abnormal SpO2 (mean SpO2 < 95%; OR = 4.91, 95% CI = 1.81–13.27) independently predicted hypertension in obese children, and severe OSAS (OR = 2.28, 95% CI = 1.27–4.10) independently predicted hypertension in non-obese children. In conclusion, obesity, OSAS severity, and abnormal SpO2 are potentially modifiable targets to improve hypertension while treating children with OSAS.

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“…Several studies have demonstrated the relationship between PWV values and lipid profile (total cholesterol, low-density-lipoprotein [LDL]-cholesterol, triglycerides), insulin resistance (Homeostatic Model Assessment of Insulin Resistance [HOMA-IR]), fasting insulin, and C-reactive protein (CRP) in children with obesity [ 11 , 12 , 13 ]. Therefore, the use of PWV measurements has been proposed as a useful prognostic index of vascular damage in children [ 14 , 15 ]. However, PWV’s role in stratifying risk in obese/overweight children has not yet been satisfactorily defined.…”

Section: Introductionmentioning

confidence: 99%

Metabolically Healthy Obesity: Presence of Arterial Stiffness in the Prepubescent Population

Ruiz-Moreno

Vilches-Pérez

Gallardo-Escribano

et al. 2020

IJERPH

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Aim: Arteriosclerotic cardiovascular disease, one of the world’s leading causes of death, first manifests itself at an early age. The identification of children who may have increased cardiovascular risk in the future could be an important prevention strategy. Our aim was to assess the clinical, analytical, and dietary variables associated with arterial stiffness (AS), measured by carotid-femoral pulse wave velocity (cfPWV) in a prepubescent population with metabolically healthy obesity (MHO). Subjects and Methods: A cross-sectional study in prepubescent subjects with obesity who had ≤1 metabolic syndrome criteria (abdominal perimeter and blood pressure ≥90th percentile, triglycerides >150 mg/dL, HDL-cholesterol <40 mg/dL, fasting plasma glucose ≥100 mg/dL) was conducted. Adherence to Mediterranean Diet, blood pressure, BMI, waist/height ratio (WHtR), glycemic status, lipid profile, and cfPWV were analyzed. 75 MHO children (boys: 43; girls: 32; p = 0.20) (age = 10.05 ± 1.29 years; BMI = 25.29 ± 3.5 kg/m2) were included. Results: We found a positive correlation between cfPWV and weight (r = 0.51; p < 0.0001), BMI (r = 0.44; p < 0.0001), WHtR (r = 0.26; p = 0.02), fasting insulin levels (r = 0.28; p = 0.02), and insulin resistance (Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index) (r = 0.25; p = 0.04). Multiple linear regression analysis identified BMI and HOMA-IR as independent parameters associated with cfPWV. Conclusions: Prepubescent children with obesity who were shown to be metabolically healthy presented with arterial stiffness, which is closely related to BMI and the state of insulin resistance.

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Overweight and obese children with sleep disordered breathing have elevated arterial stiffness

Cited by 11 publications

References 46 publications

The relationship of hypertension with obesity and obstructive sleep apnea in adolescents

The relationship of hypertension with obesity and obstructive sleep apnea in adolescents

Hypertension in Children with Obstructive Sleep Apnea Syndrome—Age, Weight Status, and Disease Severity

Metabolically Healthy Obesity: Presence of Arterial Stiffness in the Prepubescent Population

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