María Luz Alonso-Álvarez1, Joaquin Terán-Santos1, Mónica Gonzalez Martinez2, José Aurelio Cordero-Guevara3, María José Jurado-Luque4, Jaime Corral-Peñafiel5, Joaquin Duran-Cantolla6, Estrella Ordax Carbajo3, Fernando MasaJimenez5, Leila Kheirandish-Gozal7, David Gozal8. 1. Sleep Unit, Hospital Universitario de Burgos (HUBU), Burgos, Spain; CIBER of Respiratory Diseases, Instituto Carlos III, Ciberes, Spain. 2. Sleep Unit, Hospital Universitario de Burgos (HUBU), Burgos, Spain; Hospital Universitario Valdecilla, Santander, Spain. 3. Sleep Unit, Hospital Universitario de Burgos (HUBU), Burgos, Spain. 4. CIBER of Respiratory Diseases, Instituto Carlos III, Ciberes, Spain; Hospital Val D'Hebron, Barcelona, Spain. 5. CIBER of Respiratory Diseases, Instituto Carlos III, Ciberes, Spain; Hospital San Pedro de Alcantara, Caceres, Spain. 6. CIBER of Respiratory Diseases, Instituto Carlos III, Ciberes, Spain; Hospital Universitario de Araba, Vitoria, Spain. 7. Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA. 8. Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA. Electronic address: dgozal@uchicago.edu.
Abstract
OBJECTIVE:Obesity and obstructive sleep apnea in children have been associated with metabolic morbidities. The present study aimed to evaluate the presence of metabolic alterations among obese children recruited from the community, with and without obstructive sleep apnea syndrome (OSAS), and the impact of treatment of OSAS on metabolic profiles. METHODS: A cross-sectional, prospective, multicenter study of Spanish children aged 3-14 years with a body mass index (BMI) ≥95th percentile for age and sex were randomly selected in the first phase. Four groups emerged for follow-up: (1) no treatment; (2) dietary intervention; (3) surgical treatment of OSA; and (4) continuous positive airway pressure (CPAP) treatment of OSA. Fasting blood tests were performed at baseline (T0) and approximately one year after the intervention (T1). RESULTS: A total of 113 obese children with a mean age of 11.3 ± 2.9 years completed T0 and T1 assessments. Their mean BMI z-score at T1 was 1.34 ± 0.59, and mean Respiratory Disturbance Index was 8.6 ± 13.0 at T0 and 3.3 ± 4.0/hour total sleep time at T1. Only glucose fasting levels differed among metabolic parameters in obese children with OSAS and without OSAS at baseline (T0) (p = 0.018). There were statistically significant differences between surgically treated OSAS (p = 0.002), and CPAP-treated OSAS (p = 0.024) versus the non-OSAS group in the glucose levels between baseline (T0) and follow-up (T1) after controlling for age and change in BMI. Significant univariate associations between BMI and C-reactive protein, insulin, and homeostasis model assessment of insulin resistance emerged at both T0 and T1. CONCLUSIONS: Concurrent obesity and OSAS could promote metabolic and inflammatory alterations, and the latter appeared to be sensitive to OSAS treatment outcomes. ClinicalTrials.gov Identifier: NCT01322763.
RCT Entities:
OBJECTIVE:Obesity and obstructive sleep apnea in children have been associated with metabolic morbidities. The present study aimed to evaluate the presence of metabolic alterations among obesechildren recruited from the community, with and without obstructive sleep apnea syndrome (OSAS), and the impact of treatment of OSAS on metabolic profiles. METHODS: A cross-sectional, prospective, multicenter study of Spanish children aged 3-14 years with a body mass index (BMI) ≥95th percentile for age and sex were randomly selected in the first phase. Four groups emerged for follow-up: (1) no treatment; (2) dietary intervention; (3) surgical treatment of OSA; and (4) continuous positive airway pressure (CPAP) treatment of OSA. Fasting blood tests were performed at baseline (T0) and approximately one year after the intervention (T1). RESULTS: A total of 113 obesechildren with a mean age of 11.3 ± 2.9 years completed T0 and T1 assessments. Their mean BMI z-score at T1 was 1.34 ± 0.59, and mean Respiratory Disturbance Index was 8.6 ± 13.0 at T0 and 3.3 ± 4.0/hour total sleep time at T1. Only glucose fasting levels differed among metabolic parameters in obesechildren with OSAS and without OSAS at baseline (T0) (p = 0.018). There were statistically significant differences between surgically treated OSAS (p = 0.002), and CPAP-treated OSAS (p = 0.024) versus the non-OSAS group in the glucose levels between baseline (T0) and follow-up (T1) after controlling for age and change in BMI. Significant univariate associations between BMI and C-reactive protein, insulin, and homeostasis model assessment of insulin resistance emerged at both T0 and T1. CONCLUSIONS: Concurrent obesity and OSAS could promote metabolic and inflammatory alterations, and the latter appeared to be sensitive to OSAS treatment outcomes. ClinicalTrials.gov Identifier: NCT01322763.
Authors: Esther Oceja; Paula Rodríguez; María José Jurado; Maria Luz Alonso; Genoveva Del Río; María Ángeles Villar; Olga Mediano; Marian Martínez; Santiago Juarros; Milagros Merino; Jaime Corral; Carmen Luna; Leila Kheirandish-Gozal; David Gozal; Joaquín Durán-Cantolla Journal: Methods Protoc Date: 2021-01-19
Authors: Sara Rodriguez-Lopez; Stefan Palkowski; Christopher Gerdung; Diana Keto-Lambert; Meghan Sebastianski; Maria Luisa Castro-Codesal Journal: BMJ Open Date: 2020-08-30 Impact factor: 2.692