Sleep fragmentation and intermittent hypoxemia are associated with decreased insulin sensitivity in obese adolescent Latino males

Abstract

Background Although sleep-related breathing disorder (SRBD) has been linked to insulin resistance in adults, this has not been as well established in children. We hypothesized that the severity of SRBD in adolescents was associated with metabolic impairment. Methods Polysomnography was performed on obese, Latino males referred for snoring. The frequently sampled intravenous glucose tolerance test (FSIVGTT) was used to assess glucose homeostasis. Total body dual-energy X-ray absorptiometry (DEXA) was used to quantify adiposity. Results 22 males (mean age 13.4±SD 2.1 years, BMI z-score 2.4±0.3, obstructive apnea hypopnea index (OAHI) 4.1±3.2) were studied. After correcting for age and adiposity in multiple regression models, Log frequency of desaturation (defined as ≥3% drop in oxygen saturation from baseline) negatively correlated with insulin sensitivity. Sleep efficiency was positively correlated with glucose effectiveness (SG-the capacity of glucose to mediate its own disposal). The Log total arousal index was positively correlated with Log homeostasis model assessment (HOMA-IR). Conclusions Sleep fragmentation and intermittent hypoxemia are associated with metabolic impairment in obese adolescent Latino males independent of age and adiposity. We speculate that SRBD potentiates the risk for development of metabolic syndrome and type 2 diabetes in the obese adolescent population.

Interactions Between Pregnancy, Obstructive Sleep Apnea, and Gestational Diabetes Mellitus

“…After adjustment for prepregnancy BMI, higher microarousal index and more frequent oxygen desaturation events were associated with higher fasting glucose levels. These associations between sleep disturbances and reduced glucose tolerance are in agreement with those in nonpregnant populations (3,22,23).…”

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

“…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.…”

“…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.…”

Association between sleep pattern and body mass index among undergraduate health colleges’ students at Qassim University, Saudi Arabia

“…[10,11] By contrast, sleep dysfunction is linked to the development of physical and psychological issues including cardiovascular problems, diabetes, obesity, anxiety, and all-cause high rates of death [12] and number of studies have supported that the metabolic rate related to interference of normal sleep behaviors may related to the development of obesity, cardiovascular disease, diabetes, and diabetes. [13][14][15][16][17][18][19][20][21][22][23][24][25][26] In the current study, the authors applied crosssectional study that explore the association between Body Mass Index (BMI) and sleep pattern among undergraduate female students of health colleges in Qassim University.…”