Autonomic and metabolic effects of OSA in childhood obesity

Oliveira, F. M.; Tran, Winston H; Lesser, Daniel J.; Bhatia, Rajeev; Ortega, Ricardo; Mittelman, Steven D.; Keens, Thomas G.; Ward, Sally L. Davidson; Khoo, Michael C. K.

doi:10.1109/iembs.2010.5627789

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…4,5,15,16 This study investigated whether DEXA scans could be used to show that a sensitive measure of fat mass and distribution of fat correlates with SRBD in obese/ overweight pediatric patients. We found that total body fat mass and trunk fat mass as measured on DEXA scanning, as well as BMI, were associated with total arousal index and desaturation index.…”

Section: Discussionmentioning

confidence: 99%

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Body Fat Composition: A Predictive Factor for Sleep Related Breathing Disorder in Obese Children

Bhatia

Lesser

Oliveira

et al. 2015

Journal of Clinical Sleep Medicine

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Introduction:The association between body fat composition as measured by dual energy x-ray absorptiometry (DEXA) scanning and pediatric sleep related breathing disorder (SRBD) is not well established. We investigated the relationship between body mass index (BMI) and DEXA parameters and their association with SRBD in obese children. Patients and Methods: Overnight polysomnography was performed on obese/overweight children (10-17 years) with habitual snoring. Total body fat mass (g), trunk fat mass (g), total body % fat, and trunk % fat were determined by DEXA. Results: Forty-one subjects were studied. Logarithm (Log) total arousal index correlated with BMI (p < 0.01, r = 0.473), total body fat mass (p < 0.05, r = 0.331), and trunk fat mass (p < 0.05, r = 0.319). Log desaturation index correlated with BMI (p < 0.05, r = 0.313), total body fat mass (p < 0.05, r = 0.375), and trunk fat mass (p < 0.05, r = 0.391), whereas obstructive apnea hypopnea index (OAHI) did not. In males 10-12 years, there was a signifi cant correlation between Log total arousal index and obesity parameters, but not for males aged 13-17 years. BMI correlated with DEXA parameters in all subjects: total body fat mass (p < 0.001, r = 0.850); total body % fat (p < 0.01, r = 0.425); trunk fat mass (p < 0.001, r = 0.792) and trunk % fat (p < 0.05, r = 0.318) and in 10-12 year old males. This relationship was not signifi cant in males aged 13-17 years. Conclusions: Total body fat mass and trunk fat mass as well as BMI correlated with total arousal index and desaturation index. BMI correlated with DEXA parameters in 10-12 year old males but not in 13-17 year old males. The value of using DEXA scanning to study the relationship between obesity and SRBD may depend on age and pubertal stage. Keywords: pediatric obesity, body mass index, body fat composition, DEXA scan, sleep related breathing disorder, pediatric obstructive sleep apnea Citation: Bhatia R, Lesser DJ, Oliveira FG, Tran WH, Keens TG, Khoo MC, Davidson Ward SL. Body fat composition: a predictive factor for sleep related breathing disorder in obese children.

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Section: Discussionmentioning

confidence: 99%

“…1,2 In the pediatric age group, it has been associated with signifi cant metabolic and autonomic dysfunction. [3][4][5] In children obesity has been shown to be an independent risk factor for snoring and obstructive sleep apnea (OSA). 6,7 The literature also provides evidence regarding the predictors of SRBD in obese children.…”

mentioning

confidence: 99%

Body Fat Composition: A Predictive Factor for Sleep Related Breathing Disorder in Obese Children

Bhatia

Lesser

Oliveira

et al. 2015

Journal of Clinical Sleep Medicine

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“…In addition, Snow et al (2010) also showed a higher gene expression among genes that are involved in the synthesis and transport of catecholamines, as well as in selected important receptors, with such findings suggesting the presence of increased bioavailability of catecholamines. More recently, several groups have confirmed that AHI is a significant independent predictor of noradrenaline and adrenaline levels (Kelly et al, 2010; Oliveira et al, 2010; O’Driscoll et al, 2011). In a different study, Nakra et al (2008) assessed a small group of obese children and adolescents in whom norepinephrine levels were assessed hourly throughout the night before and after treatment with CPAP for 3 months.…”

Section: Autonomic Alterations In Children With Osamentioning

confidence: 94%

Sympathetic and Catecholaminergic Alterations in Sleep Apnea with Particular Emphasis on Children

Hakim¹,

Gozal²,

Kheirandish‐Gozal³

2012

Front. Neur.

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Sleep is involved in the regulation of major organ functions in the human body, and disruption of sleep potentially can elicit organ dysfunction. Obstructive sleep apnea (OSA) is the most prevalent sleep disorder of breathing in adults and children, and its manifestations reflect the interactions between intermittent hypoxia, intermittent hypercapnia, increased intra-thoracic pressure swings, and sleep fragmentation, as elicited by the episodic changes in upper airway resistance during sleep. The sympathetic nervous system is an important modulator of the cardiovascular, immune, endocrine and metabolic systems, and alterations in autonomic activity may lead to metabolic imbalance and organ dysfunction. Here we review how OSA and its constitutive components can lead to perturbation of the autonomic nervous system in general, and to altered regulation of catecholamines, both of which then playing an important role in some of the mechanisms underlying OSA-induced morbidities.

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“…Since OSA is strongly connected to autonomic dysfunction, the potential contribution of autonomic alterations to metabolic morbidities in the context of OSA can not be ignored (Trombetta et al, 2010; Spiegel et al, 2004). The extent of such connection in children has however not been as thoroughly explored as it should (Oliveira et al, 2010). Indeed, a substantial number of studies has suggested the presence of significant associations between the spectrum of sleep disordered breathing in children and insulin resistance and alterations in lipid homeostasis (Alexopoulos et al, 2011; Canapari et al, 2011; Deboer et al, 2012; Hannon et al, 2011; Nakra et al, 2008; Tauman et al, 2005; Tsaoussoglou et al, 2010; Verhulst et al, 2009; Waters et al, 2007).…”

Section: Autonomic Nervous System Alterations In Children With Osamentioning

confidence: 99%

Chemoreceptors, baroreceptors, and autonomic deregulation in children with obstructive sleep apnea

Gozal

Hakim

Kheirandish‐Gozal

2013

Respiratory Physiology & Neurobiology

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Obstructive sleep apnea (OSA) is highly prevalent sleep disorder of breathing in both adults and children that is fraught with substantial cardiovascular morbidities, the latter being attributable to a complex interplay between intermittent hypoxia (IH), episodic hypercapnia, recurrent large intra-thoracic pressure swings, and sleep disruption. Alterations in autonomic nervous system function could underlie the perturbations in cardiovascular, neurocognitive, immune, endocrine and metabolic functions that affect many of the patients suffering from OSA. Although these issues have received substantial attention in adults, the same has thus far failed to occur in children, creating a quasi misperception that children are protected. Here, we provide a critical overview of the evidence supporting the presence of autonomic nervous system (ANS) perturbations in children with OSA, draw some parallel assessments to known mechanisms in rodents and adult humans, particularly, peripheral and central chemoreceptor and baroreceptor pathways, and suggest future research directions.

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Autonomic and metabolic effects of OSA in childhood obesity

Cited by 5 publications

References 25 publications

Body Fat Composition: A Predictive Factor for Sleep Related Breathing Disorder in Obese Children

Body Fat Composition: A Predictive Factor for Sleep Related Breathing Disorder in Obese Children

Sympathetic and Catecholaminergic Alterations in Sleep Apnea with Particular Emphasis on Children

Chemoreceptors, baroreceptors, and autonomic deregulation in children with obstructive sleep apnea

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