The Role of Brain-Derived Neurotrophic Factor in Obstructive Sleep Apnea and Endothelial Function in a Pediatric Population With Obesity

Abstract

BackgroundChildhood obesity has increased worldwide, becoming a significant public health concern. Brain-derived neurotrophic factor (BDNF) plays an important role in the central regulation of food intake and body weight, but little is known regarding its role in childhood obesity. Next to obesity, BDNF has been linked to obstructive sleep apnea (OSA) and endothelial dysfunction, two obesity-related comorbidities. The aim of this study is to investigate how BDNF, OSA and endothelial dysfunction interact in children with obesity and to determine the effect of weight loss on serum BDNF levels.MethodsChildren and adolescents with obesity aged 8–18 years who were enrolled in a multidisciplinary obesity treatment (MOT) in a tertiary hospital, were prospectively included. Several examinations were conducted during this MOT; at baseline, after 6 months and after 12 months, including the assessment of endothelial function, body composition measurements and a polysomnography. BDNF levels were measured on a serum sample by means of ELISA.ResultsA total of 103 patients with obesity was included, of which 20 had OSA (19.4%). BDNF levels were comparable in children with obesity and OSA and children with obesity but without OSA (26.75 vs. 27.87 ng/ml, p = 0.6). No correlations were found between BDNF and sleep-related variables or between BDNF and endothelial function parameters nor between BDNF and adiposity measures. To investigate if the interaction between OSA and endothelial dysfunction had an influence on BDNF levels, a general linear model was used. This model revealed that a diagnosis of OSA, as well as the interaction between OSA and maximal endothelial dilatation, contributed significantly (p = 0.03, p = 0.04, respectively) to BDNF levels. After 1 year of weight loss therapy, BDNF levels did not change (26.18 vs. 25.46 ng/ml, p = 0.7) in our population.ConclusionBDNF concentrations were comparable in children with obesity, both with and without OSA, indicating that BDNF levels are not affected by OSA. However, we did find an interaction effect of OSA and endothelial function on BDNF levels.

Relationship between serum brain-derived neurotrophic factor and cognitive impairment in children with sleep-disordered breathing

“…In addition, the association between circulating levels of BDNF and children with SDB is also still unclear. Consistent with our findings, Bahgat et (31,32). The results and patients were not evaluated in terms of OAHI ≥ 1 in these studies, which could explain the discrepancy in the results.…”

“…Moreover, a significant difference was also found in serum BDNF levels between OSA children and PS children. In contrast, studies by Makhout et al and Wang et al have shown that BDNF levels are not affected by OSA in children ( 31 , 32 ). The results and patients were not evaluated in terms of OAHI ≥ 1 in these studies, which could explain the discrepancy in the results.…”

BDNF and proBDNF Serum Protein Levels in Obstructive Sleep Apnea Patients and Their Involvement in Insomnia and Depression Symptoms

“…Our study didn’t find any significant differences in BDNF and proBDNF levels between OSA and the healthy control group. Interestingly, most human studies on BDNF in OSA showed no differences in BDNF levels [ 30 , 31 , 32 , 57 , 58 , 59 ]. On the other hand, Shah et al showed increased BDNF expression in the soft palate muscles of snorers and patients with OSA [ 60 ].…”

Evaluation of HIF-1 Involvement in the BDNF and ProBDNF Signaling Pathways among Obstructive Sleep Apnea Patients

“…Further, the groups were not age-matched, which should be taken into consideration. Regardless the available data on differences in the BDNF levels in similar comparisons in the literature is inconclusive, with the majority of studies similarly not noting any changes in the level of this protein [ 34 , 35 , 36 , 37 , 38 ]. In opposition are the results obtained by Flores et al, who, in their study, observed an increased level of the BDNF serum protein level in OSA patients compared to the control group [ 39 ].…”