Sleep-disordered breathing in obese adolescents is associated with visceral adiposity and markers of insulin resistance

Abstract

Sleep-disordered breathing is associated with obesity, insulin resistance, and the metabolic syndrome in adults. Similar data in children is limited and conflicting. This pilot study examined the relationships between sleep-disordered breathing, visceral adiposity, and cardiometabolic risk factors in obese adolescents. Twenty obese (body mass index ≥95^th percentile), otherwise healthy adolescents (age 14.9 ± 2 years) underwent polysomnogram studies, fasting lipid profile and oral glucose tolerance tests, and measures of body composition (dual-energy X-ray absorptiometry) and visceral adiposity (abdominal computed tomography). The severity of sleep-disordered breathing (as measured by apnea-hypopnea index) was positively associated with visceral adipose tissue (r=0.73, p<0.001) but not with other measures of body composition. After controlling for body mass index, the severity of sleep-disordered breathing was positively associated with markers of insulin resistance (homeostasis model assessment and fasting insulin). Further study to allow for critical assessment of the relationships between sleep-disordered breathing and cardiometabolic risk factors in obese youth remains necessary.

Key words::

• Sleep apnea
• insulin resistance
• central adiposity
• abdominal obesity

Acknowledgements

Support for this study was provided by the Pittsburgh Foundation M2007-0064 (TH), Children's Hospital of Pittsburgh Research Advisory Committee (TH), US Department of Defense W81XWH-06-2-0024 (SL; PI: SA), National Center for Research Resources (NCRR) UL1-RR024153 (YL), US Public Health Service Grant K24-HD01357 (SA), US Public Health Service Grant K12-DK063704 Grant Scholar (TH; PI: SA), and the Pediatric Clinical and Translational Research Center at Children's Hospital of Pittsburgh (NIH/NCRR/CTSA Grant UL1-RR024153).

The funding agencies approved the study design but did not have a role in the collection, analysis, or interpretation of data; the writing of the report; or the decision to submit the manuscript for publication.

Declaration of interest: The authors report no conflicts of interest. Tamara Hannon wrote the manuscript and no payment of any form was given to produce the manuscript. The authors alone are responsible for the content and writing of the paper.