title: Waist circumference predicts the occurrence of sleep-disordered breathing in obese children and adolescents: a questionnaire-based study.
abstract: OBJECTIVE
  To assess the presence of sleep-disordered breathing (SDB) in a population of obese children and adolescents and to investigate the role of fat distribution in predicting SDB.
  
  
  METHODS
  One hundred and thirty-two obese children and adolescents, aged 5.0-14.2 years, were consecutively referred to the Department of Pediatrics of the Second University of Naples for screening of obesity. The control group consisted of 453, sex- and age-matched lean subjects selected from local schools in Campania region. The sleep disturbances scale for children (SDSC) questionnaire was used to evaluate SDB prevalence. In all subjects, waist circumference, triceps and sub-scapular skin folds were measured, and Z-scores were calculated.
  
  
  RESULTS
  Obese subjects showed significantly higher SDB and sleep hyperhydrosis (SHY) scores than controls. The Z-score of waist circumference correlated with SDB (r=0.32; P=0.006) and SHY factor scores (r=0.37; P=0.005), while the Z-score of body mass index (BMI), triceps and sub-scapular skin folds were not correlated with any SDSC factor scores. Subjects in the higher tertile for Z-score of waist circumference had a significantly higher risk for developing SDB (OR 1.9; 95% IC 1.8-3.2) and SHY (OR 2.1; 95% IC 2.0-4.5).
  
  
  CONCLUSIONS
  Waist circumference is a more reliable index than total adiposity and subcutaneous fat in predicting the risk of obese children to develop SDB.
authors.affiliation: Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Via Luigi Pansini no. 5-PAD XI, 80131 Naples, Italy. marco.carotenuto@unina2.it
authors.forename: Marco
authors.initials: M
authors.lastname: Carotenuto
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
authors.forename: Nicola
authors.initials: N
authors.lastname: Santoro
authors.forename: Emanuele Miraglia
authors.initials: EM
authors.lastname: Del Giudice
authors.forename: Laura
authors.initials: L
authors.lastname: Perrone
authors.forename: Antonio
authors.initials: A
authors.lastname: Pascotto
mesh_terms: D000273:Adipose Tissue; D000293:Adolescent; D000886:Anthropometry; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D049629:Waist-Hip Ratio