BACKGROUND: Obstructive sleep apnea (OSA) is associated with obesity, inflammation, and insulin resistance. The role of fat distribution in OSA pathogenesis has not been established in children. The objective of the study is to examine the relationship between fat distribution, OSA, and insulin resistance in an unselected population of obese children. METHODS: All obese (BMI > 95th percentile) children (ages 5-18 y) seen at a pediatric obesity clinic were invited to participate. Subjects underwent polysomnography, and were tested for dyslipidemia, inflammation, and insulin resistance measured by the homeostasis model assessment (HOMA). In a subset of subjects, magnetic resonance (MRI) imaging was used to determine the abdominal visceral and subcutaneous adipose tissue areas and magnetic resonance spectroscopy (MRS) spectroscopy was used to intramyocellular lipids in leg muscles. MEASUREMENTS AND MAIN RESULTS: 31 obese subjects enrolled and completed polysomnography and serum testing, and 19 subjects underwent MRI/MRS. The mean age was 12.6 ± 3.0 y and the mean body mass index (BMI) was 39.5 ± 11.2 kg/m(2). Forty-eight percent had OSA (mean apnea hypopnea index [AHI] 6.26 ± 6.77 events/h) Subjects with OSA had significantly increased BMI, log HOMA, triglycerides, and leptin compared to those without OSA. In regression analysis, only BMI z-score was associated with log HOMA. In the subset of patients with imaging data, visceral fat area was strongly predictive of AHI (p = 0.003, r(2) = 0.556). BMI z-score, gender, and age were not predictive. CONCLUSIONS: Visceral fat distribution is independently predictive of OSA severity in obese children.
BACKGROUND: Obstructive sleep apnea (OSA) is associated with obesity, inflammation, and insulin resistance. The role of fat distribution in OSA pathogenesis has not been established in children. The objective of the study is to examine the relationship between fat distribution, OSA, and insulin resistance in an unselected population of obesechildren. METHODS: All obese (BMI > 95th percentile) children (ages 5-18 y) seen at a pediatric obesity clinic were invited to participate. Subjects underwent polysomnography, and were tested for dyslipidemia, inflammation, and insulin resistance measured by the homeostasis model assessment (HOMA). In a subset of subjects, magnetic resonance (MRI) imaging was used to determine the abdominal visceral and subcutaneous adipose tissue areas and magnetic resonance spectroscopy (MRS) spectroscopy was used to intramyocellular lipids in leg muscles. MEASUREMENTS AND MAIN RESULTS: 31 obese subjects enrolled and completed polysomnography and serum testing, and 19 subjects underwent MRI/MRS. The mean age was 12.6 ± 3.0 y and the mean body mass index (BMI) was 39.5 ± 11.2 kg/m(2). Forty-eight percent had OSA (mean apnea hypopnea index [AHI] 6.26 ± 6.77 events/h) Subjects with OSA had significantly increased BMI, log HOMA, triglycerides, and leptin compared to those without OSA. In regression analysis, only BMI z-score was associated with log HOMA. In the subset of patients with imaging data, visceral fat area was strongly predictive of AHI (p = 0.003, r(2) = 0.556). BMI z-score, gender, and age were not predictive. CONCLUSIONS: Visceral fat distribution is independently predictive of OSA severity in obesechildren.
Authors: Ram Weiss; Sylvie Dufour; Sara E Taksali; William V Tamborlane; Kitt F Petersen; Riccardo C Bonadonna; Linda Boselli; Gina Barbetta; Karin Allen; Francis Rife; Mary Savoye; James Dziura; Robert Sherwin; Gerald I Shulman; Sonia Caprio Journal: Lancet Date: 2003-09-20 Impact factor: 79.321
Authors: Raouf Amin; Leonard Anthony; Virend Somers; Matthew Fenchel; Keith McConnell; Jenny Jefferies; Paul Willging; Maninder Kalra; Stephen Daniels Journal: Am J Respir Crit Care Med Date: 2008-01-03 Impact factor: 21.405
Authors: Stijn L Verhulst; Koen Van Hoeck; Nancy Schrauwen; Dominique Haentjens; Raoul Rooman; Luc Van Gaal; Wilfried A De Backer; Kristine N Desager Journal: Chest Date: 2007-05-15 Impact factor: 9.410
Authors: Alan R Schwartz; Susheel P Patil; Alison M Laffan; Vsevolod Polotsky; Hartmut Schneider; Philip L Smith Journal: Proc Am Thorac Soc Date: 2008-02-15
Authors: Daniel J Lesser; Rajeev Bhatia; Winston H Tran; Flavia Oliveira; Ricardo Ortega; Thomas G Keens; Steven D Mittelman; Michael C K Khoo; Sally L Davidson Ward Journal: Pediatr Res Date: 2012-06-05 Impact factor: 3.756
Authors: P E Brockmann; F Damiani; D L Smith; A Castet; F Nuñez; L Villarroel; D Gozal Journal: Int J Obes (Lond) Date: 2016-08-01 Impact factor: 5.095
Authors: Talih Ozdas; Kursat Murat Ozcan; Fatih Ozdogan; Ibrahim Ozcan; Adin Selcuk; Mehmet Ali Cetin; Huseyin Dere Journal: Eur Arch Otorhinolaryngol Date: 2012-10-12 Impact factor: 2.503
Authors: Jordan Gaines; Alexandros N Vgontzas; Julio Fernandez-Mendoza; Susan L Calhoun; Fan He; Duanping Liao; Marjorie D Sawyer; Edward O Bixler Journal: Am J Physiol Endocrinol Metab Date: 2016-09-20 Impact factor: 4.310