Original articleSleep-Disordered Breathing and the Metabolic Syndrome in Overweight and Obese Children and Adolescents
Section snippets
Methods
Consecutive subjects aged 6 to 17 years who were overweight or obese were recruited between January 2001 and September 2006 at the Pediatric Obesity Clinic of the Antwerp University Hospital. Children were excluded when they had any chronic medical condition, any genetic, neuromuscular, or craniofacial syndromes, or were receiving medications that are known to affect glucose homeostasis or serum lipid levels. Patients were classified as prepubertal or pubertal on the basis of a combination of
Results
A total of 104 subjects were studied; 44% were boys, and 58% were prepubertal, with a mean age of 11.1 ± 2.6 years (range, 6.1-16.7 years). The mean BMI z-score was 2.3 ± 0.5 (range, 1.3-3.8); 32 subjects (31%) were overweight, and 72 subjects (69%) were obese. No subject had diabetes mellitus.
The MS was present in 34 of 93 subjects (37%). In 11 subjects, the diagnosis of the MS could not be made, because of laboratory errors. Subjects with the MS had a higher waist circumference (88.5 ± 12.6
Discussion
The features comprising the metabolic or insulin-resistance syndrome are hyperinsulinemia, dyslipidemia, central obesity, and hypertension.27 Several reports have documented the prevalence of the MS in pediatric obesity.28, 29 Furthermore, high fasting insulin levels and increased BMI during childhood are strong predictors of the MS in adulthood,30 and children with insulin resistance have an increased risk of future cardiovascular morbidity and mortality.31 By aggravating the obesity-related
references (36)
- et al.
Left ventricular function in children with sleep-disordered breathing
Am J Cardiol
(2005) - et al.
CPAP treatment does not affect glucose-insulin metabolism in sleep apneic patients
Sleep Med
(2001) - et al.
Metabolic correlates with obstructive sleep apnea in obese subjects
J Pediatr
(2002) - et al.
Pituitary reactivity, androgens and catecholamines in obstructive sleep apnoeaEffects of continuous positive airway pressure treatment (CPAP)
Respir Med
(1999) - et al.
Twenty-four-hour ambulatory blood pressure in children with sleep-disordered breathing
Am J Respir Crit Care Med
(2004) - et al.
Blood pressure in children with obstructive sleep apnea
Am J Respir Crit Care Med
(1998) - et al.
Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea
Am J Respir Crit Care Med
(2002) - et al.
Obstructive sleep apnea: implications for cardiac and vascular disease
JAMA
(2003) - et al.
Insulin levels, blood pressure and sleep apnea
Sleep
(1994) - et al.
Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia
J Clin Endocrinol Metab
(2000)