Association between inadequate sleep and insulin resistance in obese children.
OBJECTIVE
To analyze the relationships between sleep duration, obstructive sleep apnea syndrome (OSAS), and markers of insulin resistance in obese children.


METHODS
Forty obese children were evaluated for sleep-related complaints. Each child underwent a polysomnogram, an oral glucose tolerance test (OGTT), and fasting lipid panel tests. Indices of insulin resistance (HOMA-IR and WBISI) and insulin secretion (IGI) were calculated based on the results of the OGTT. Markers of insulin resistance were compared among groups categorized according to polysomnogram results.


RESULTS
Subjects with shorter sleep duration had higher fasting insulin, peak insulin, and HOMA-IR levels and lower WBISI levels, findings suggestive of insulin resistance. In contrast, differences in body mass index z scores were not observed. Subjects with OSAS (32 of 40 children) had higher triglyceride levels and HOMA-IR values than those without OSAS, but did not differ in sleep duration. Multiple linear regression analysis revealed that HOMA-IR was significantly correlated with age, sleep duration, and percentage of rapid-eye-movement sleep.


CONCLUSIONS
Insulin resistance in obese children is associated with short sleep duration and OSAS.
Flint
Janna
J
Section of Endocrinology, St Christopher's Hospital for Children, Philadelphia, Pennsylvania 19134, USA. janna.flint@tenethealth.com
Kothare
Sanjeev V
SV
Zihlif
Mamoon
M
Suarez
Elizabeth
E
Adams
Ruth
R
Legido
Agustin
A
De Luca
Francesco
F
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose; D015984:Causality; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D015143:Philadelphia / Q000453:epidemiology; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D013997:Time Factors
D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin