Sleep-associated breathing disorders in morbidly obese children and adolescents

Mallory, George B.; Fiser, Debra H.; Jackson, Rithea

doi:10.1016/s0022-3476(89)80738-3

Cited by 282 publications

(176 citation statements)

References 15 publications

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“…Obstructive sleep apnea (OSA) is more prevalent in children with obesity (13% to 66%), [1][2][3][4] than those who are non-obese (1.2% to 5.7%). 5 OSA is associated with signifi cant morbidity, including learning and behavioral diffi culties, cardiovascular disease, metabolic dysfunction, and impaired quality of life.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Does Neck-to-Waist Ratio Predict Obstructive Sleep Apnea in Children?

Katz

Vaccani

Barrowman

et al. 2014

Journal of Clinical Sleep Medicine

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Objectives: Central adiposity and large neck circumference are associated with obstructive sleep apnea (OSA) in adults but have not been evaluated in children as predictors of OSA. Study objectives were to determine whether (1) anthropometric measures including neck-to-waist ratio are associated with OSA in older children; (2) body fat distribution, measured by neck-to-waist ratio, is predictive of OSA in overweight/obese children. Methods: Cross-sectional study involving children 7-18 years scheduled to undergo polysomnography at a tertiary care children's hospital. OSA was defi ned as total apnea-hypopnea index > 5 events/h and/or obstructive apnea index > 1 event/h. Recursive partitioning was used to select candidate predictors of OSA from: age, sex, height and weight percentile, body mass index (BMI) z-score, neck-to-waist ratio, tonsil size, and Mallampati score. These were then evaluated using log binomial models and receiver operator characteristic analysis. Results: Two hundred twenty-two participants were included; 133 (60%) were overweight/obese, 121 (55%) male,47 (21%) had OSA. Neck-to-waist ratio (relative risk [RR] 1.97 per 0.1 units, 95% CI 1.48 to 2.84) and BMI z-score (RR 1.63 per unit, 95% CI 1.30 to 2.05) were identifi ed as independent predictors of OSA. Considering only overweight/obese children, neckto-waist ratio (RR 2.16 per 0.1 units, 95% CI 1.79 to 2.59) and BMI z-score (RR 2.02 per unit, 95% CI 1.25 to 3.26) also independently predicted OSA. However, in children not overweight/obese, these variables were not predictive of OSA. Conclusions: Neck-to-waist ratio, an index of body fat distribution, predicts OSA in older children and youth, especially in those who were overweight/obese.

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Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Does Neck-to-Waist Ratio Predict Obstructive Sleep Apnea in Children?

Katz

Vaccani

Barrowman

et al. 2014

Journal of Clinical Sleep Medicine

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“…Os problemas com crianças obesas incluem distúrbios metabólicos e físicos, além de estresse psicossocial. Alterações da função respiratória foram relatadas em muitos estudos [2][3][4] .…”

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Impact of obesity on ventilatory function

et al. 2007

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ResumoObjetivo: Embora a obesidade tenha sido associada ao comprometimento grave da ventilação, a maior parte da população estudada constitui-se de adultos com obesidade mórbida. Nosso objetivo foi investigar os efeitos da obesidade leve na função ventilatória de pacientes pediátricos.Métodos: Estudo transversal controlado que analisou 80 pacientes (M/F: 35/45) avaliados em nosso ambulatório, com queixa de sobrepeso, sem histórico de asma ou de outras atopias, comparando-os a um grupo controle com 50 crianças de peso normal controladas para a idade e para o sexo. A média de idade dos pacientes foi de 9,7±2,5 anos (7 a 15 anos). AbstractObjective: Although obesity was found to be associated with severe impairment of ventilation, most of the study population has been morbidly obese adults. We aimed to explore the effects of mild obesity on ventilatory function in the pediatric age group. Methods:In a cross-sectional controlled study, 80 patients (M/F: 35/45), who were evaluated in our outpatient clinic with the complaint of excess body weight, with no history of asthma or other atopic diseases were studied and compared to a control group of 50 normal weight children controlled for age and sex. The mean age of patients was 9.7±2.5 years (7 to 15 years). Anthropometric measurements and spirometry were performed in all subjects. Forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were used as measures of ventilatory function.Results: There were no significant differences in FEV1%, FVC% and FEV1%/FVC% by study group (p > 0.05). Only three patients had obstructive abnormalities documented on their pulmonary function tests (two had moderately severe and one had mild obstructive abnormalities).No correlation was observed between pulmonary function parameters and anthropometric measurements.Conclusion: These data demonstrate that pulmonary function test parameters of the mildly obese children were similar to those of the normal weight children. Anthropometric measurements had no significant effect on spirometric measurements in children as they did on adults.J Pediatr (Rio J). 2007;83(2):171-176: Obesity, ventilatory function, spirometry.

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“…Rarely, severe childhood obesity is associated with immediate morbidity resulting from conditions such as slipped capital femoral epiphysis, 16 whereas steatohepatitis and sleep apnea are more common. [17][18][19][20][21] Medical conditions new to this age group, such as type 2 diabetes mellitus, 22 represent "adult" morbidities that are now seen more frequently among overweight adolescents. 23 Most medical complications, however, do not become clinically apparent for decades.…”

mentioning

confidence: 99%

Screening and Interventions for Childhood Overweight: A Summary of Evidence for the US Preventive Services Task Force

et al. 2005

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ABSTRACT. Background. Childhood and adolescent overweight and obesity are related to health risks, medical conditions, and increased risk of adult obesity, with its attendant effects on morbidity and mortality rates. The prevalence of childhood overweight and obesity has more than doubled in the past 25 years.Purpose. This evidence synthesis examines the evidence for the benefits and harms of screening and early treatment of overweight among children and adolescents in clinical settings.Methods. We developed an analytic framework and 7 key questions representing the logical evidence connecting screening and weight control interventions with changes in overweight and behavioral, physiologic, and health outcomes in childhood or adulthood. We searched Results. Although BMI is a measure of relative weight rather than adiposity, it is recommended widely for use among children and adolescents to determine overweight and is the currently preferred measure. The risk of adult overweight from childhood overweight provides the best available evidence to judge the clinical validity of BMI as an overweight criterion for children and adolescents. BMI measures in childhood track to adulthood moderately or very well, with stronger tracking seen for children with >1 obese parent and children who are more overweight or older. The probability of adult obesity (BMI of >30 kg/m 2 ) is >50% among children >13 years of age whose BMI percentiles meet or exceed the 95th percentile for age and gender. BMI-based overweight categorization for individuals, particularly for racial/ethnic minorities with differences in body composition, may have limited validity because BMI measures cannot differentiate between increased weight for height attributable to relatively greater fat-free mass (muscle, bone, and fluids) and that attributable to greater fat. No trials of screening programs to identify and to treat childhood overweight have been reported. Limited research is available on effective, generalizable interventions for overweight children and adolescents that can be conducted in primary care settings or through primary care referrals.Conclusions.

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Sleep-associated breathing disorders in morbidly obese children and adolescents

Cited by 282 publications

References 15 publications

Does Neck-to-Waist Ratio Predict Obstructive Sleep Apnea in Children?

Does Neck-to-Waist Ratio Predict Obstructive Sleep Apnea in Children?

Impact of obesity on ventilatory function

Screening and Interventions for Childhood Overweight: A Summary of Evidence for the US Preventive Services Task Force

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