Obstructive sleep apnea in pediatric obesity and the effects of sleeve gastrectomy

Kanney, Michelle L.; Harford, Kelli-Lee; Leu, Roberta M.

doi:10.1016/j.sempedsurg.2020.150887

Cited by 10 publications

(3 citation statements)

References 56 publications

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“…The prevalence of OSA increases linearly with age, with approximately 50% of healthy elderly adults over 65 years of age having mild to severe OSA and 20% having mild to moderate OSA [20]. The prevalence of OSA in children ranges from 1% to 4%, but obesity increases it from 5.7% to 56% [21,22]. In children, especially those from 2 to 8 years old, large lymphoid tissues in the upper airway and enlarged tonsils are also seen as risk factors for moderate to severe OSA [23,24].…”

Section: Of 15mentioning

confidence: 99%

Revisiting the Role of Serotonin in Sleep-Disordered Breathing

Aung,

Amorim,

Mendelowitz

et al. 2024

IJMS

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Serotonin or 5-hydroxytryptamine (5-HT) is a ubiquitous neuro-modulator–transmitter that acts in the central nervous system, playing a major role in the control of breathing and other physiological functions. The midbrain, pons, and medulla regions contain several serotonergic nuclei with distinct physiological roles, including regulating the hypercapnic ventilatory response, upper airway patency, and sleep–wake states. Obesity is a major risk factor in the development of sleep-disordered breathing (SDB), such as obstructive sleep apnea (OSA), recurrent closure of the upper airway during sleep, and obesity hypoventilation syndrome (OHS), a condition characterized by daytime hypercapnia and hypoventilation during sleep. Approximately 936 million adults have OSA, and 32 million have OHS worldwide. 5-HT acts on 5-HT receptor subtypes that modulate neural control of breathing and upper airway patency. This article reviews the role of 5-HT in SDB and the current advances in 5-HT-targeted treatments for SDB.

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Section: Of 15mentioning

confidence: 99%

Revisiting the Role of Serotonin in Sleep-Disordered Breathing

Aung,

Amorim,

Mendelowitz

et al. 2024

IJMS

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“…The prevalence of paediatric OSA ranges from 1.2% to 5.7% [ 3 ]. However, it affects 5.7–56% of obese children [ 4 ]. This condition is the most common among children aged 2–8 years, as the size of the lymphoid tissues of the upper airways is the largest during these years [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of possible risk factors for the severity of paediatric obstructive sleep apnoea syndrome

Dékány,

Molnár,

Molnár

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose This study aimed to determine the effect of body mass index (BMI) percentile, asthma, sex, and age on the paediatric obstructive sleep apnoea (OSA) severity. Furthermore, to determine the possible predictive role of the BMI percentile and age in severe OSA. Methods This retrospective study included 921 children aged 2–18 years diagnosed with OSA by polysomnography. Analysis of Covariance (ANCOVA), Spearman’s correlation, Receiver Operating Characteristics (ROC) analyses were performed and area under the curve (AUC) was determined. Results We observed a significant association between a higher BMI percentile and the severity of OSA (p < 0.001, ρ = 0.15). The correlation also was significant under (p = 0.007, ρ = 0.11) and over 7 (p = 0.0002, ρ = 0.23) years of age. There was no association between the severity of OSA and the presence of asthma (p = 0.9) or sex (p = 0.891), respectively. Age was significantly related to OSA severity (p = 0.01, ρ = 0.08). Although both the BMI percentile (0.59 AUC [0.54–0.65]) and age (0.58 AUC [0.52–0.63]) predicted severe OSA, according to the sensitivity and specificity values of the ROC curve, the association presents a slight clinical relevance. Conclusions OSA severity is determined by the BMI percentile and age in children; however, these factors are unsuitable for predicting severe OSA in clinical practice. Based on our results, obesity is also a significant risk factor for OSA in younger children. Our study highlights that older, overweight, and obese children have a higher risk for severe OSA.

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“…However, there is a growing body of evidence that there are significant beneficial changes in gastric physiology, including altered neurohumoral signaling resulting in decreased serum levels of ghrelin, a hormone known to stimulate the hunger reflex, increases in serum cholecystokinin (CCK) that stimulates insulin secretion, increased GIP, GLP1, and GLP2 which play key roles in diabetes resolution and metabolic control, and microbial ecology that may alter the Gut-Brain axis, factors that are all thought to contribute to weight loss and metabolic benefits following surgery [ 11 – 13 ]. The most notable changes that occur following VSG surgery in obese patients is a significant remission in obesity-related diseases including type 2 diabetes (T2D) [ 14 , 15 ], Non-alcoholic fatty liver (NAFLD) [ 16 , 17 ], chronic kidney disease [ 18 ], cardiovascular disease [ 19 ], obstructive sleep apnea [ 20 ], as well as non-obesity-related diseases such as gout, musculoskeletal problems, ovarian disorders and urinary incontinence [ 21 ]. Recent studies showed that among obese patients (BMI’s from 27–43) with T2D, sleeve gastrectomy with intensive medical therapy was more effective in reducing hyperglycemia than intensive medical therapy alone [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in interstitial cells and gastric excitability in a mouse model of sleeve gastrectomy

et al. 2022

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Obesity is a critical risk factor of several life-threatening diseases and the prevalence in adults has dramatically increased over the past ten years. In the USA the age-adjusted prevalence of obesity in adults was 42.4%, i.e., with a body mass index (BMI, weight (kg)/height (m)2) that exceeds 30 kg/m2. Obese individuals are at the higher risk of obesity-related diseases, co-morbid conditions, lower quality of life, and increased mortality more than those in the normal BMI range i.e., 18.5–24.9 kg/m2. Surgical treatment continues to be the most efficient and scientifically successful treatment for obese patients. Sleeve gastrectomy or vertical sleeve gastrectomy (VSG) is a relatively new gastric procedure to reduce body weight but is now the most popular bariatric operation. To date there have been few studies examining the changes in the cellular components and pacemaker activity that occur in the gastric wall following VSG and whether normal gastric activity recovers following VSG. In the present study we used a murine model to investigate the chronological changes of gastric excitability including electrophysiological, molecular and morphological changes in the gastric musculature following VSG. There is a significant disruption in specialized interstitial cells of Cajal in the gastric antrum following sleeve gastrectomy. This is associated with a loss of gastric pacemaker activity and post-junctional neuroeffector responses. Over a 4-month recovery period there was a gradual return in interstitial cells of Cajal networks, pacemaker activity and neural responses. These data describe for the first time the changes in gastric interstitial cells of Cajal networks, pacemaker activity and neuroeffector responses and the time-dependent recovery of ICC networks and normalization of motor activity and neural responses following VSG.

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Obstructive sleep apnea in pediatric obesity and the effects of sleeve gastrectomy

Cited by 10 publications

References 56 publications

Revisiting the Role of Serotonin in Sleep-Disordered Breathing

Revisiting the Role of Serotonin in Sleep-Disordered Breathing

Analysis of possible risk factors for the severity of paediatric obstructive sleep apnoea syndrome

Changes in interstitial cells and gastric excitability in a mouse model of sleeve gastrectomy

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