Adipokines in children with sleep disordered breathing.
OBJECTIVE
Associations between SDB, the metabolic syndrome, and circulating levels of adipokines have emerged in adults but have not been examined in snoring children, who, in contradistinction to adults, display insulin resistance and lipid abnormalities as a function of adiposity rather than SDB. Therefore, we aimed to examine associations between circulating adipokines levels, insulin resistance, and measures of SDB in children.


METHODS
Prospective study.


METHODS
Polysomnographic evaluation and assessment of plasma levels of leptin, adiponectin, resistin, glucose, insulin, and CRP.


METHODS
130 children (mean age 8.2 +/- 2.8 years; 39% obese) were studied.


RESULTS
Log adiponectin levels were lower in obese than nonobese children (3.8 +/- 0.31 vs 4.0 +/- 0.30 corresponding to 8,381.4 +/- 5,841.0 vs 12,853.2 +/- 7,780.2 ng/ml, P < 0.0001) and were inversely correlated with BMI Z scores (r = -0.47, P < 0.0001) but not with log AHI. Log leptin concentrations were higher in the obese group than the nonobese group (4.2 +/- 0.32 vs 3.4 +/- 0.57 corresponding to 19,542.6 +/- 13,643.6 vs 5,875.5 +/- 8,425.7 pg/ml, P < 0.0001), correlated with BMI Z scores (r = 0.64, P < 0.0001), and were significantly lower in children with AHI < or = 1/hr than children with AHI > 1/hr (P = 0.006) and in children with SpO2 nadir > or = 90% than children with SpO2 nadir < 90%, even after controlling for BMI Z score (P < 0.03). No significant differences were found in log resistin levels as a function of obesity or AHI. Significant correlations between log adiponectin levels and log Insulin/Glucose (I/G) ratios (-0.28, P = 0.006) and between log leptin levels and log I/G ratios (r = 0.66, P < 0.0001) emerged.


CONCLUSIONS
In close agreement with the absence of a measurable effect of SDB on insulin resistance in children, circulating adipokines levels are primarily attributable to the ponderal index. However, SDB and associated hypoxemia may contribute to the elevation of leptin levels.
Tauman
Riva
R
Kosair Children's Hospital Research Institute, Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville, Louisville, KY 40202, USA.
Serpero
Laura D
LD
Capdevila
Oscar Sans
OS
O'Brien
Louise M
LM
Goldbart
Aviv D
AD
Kheirandish-Gozal
Leila
L
Gozal
David
D
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007301:Insect Hormones / Q000097:blood*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D020738:Leptin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis; D009765:Obesity / Q000097:blood; D009842:Oligopeptides / Q000097:blood*; D017286:Polysomnography; D011761:Pyrrolidonecarboxylic Acid / Q000031:analogs & derivatives* / Q000097:blood; D052243:Resistin / Q000097:blood; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000175:diagnosis; D013223:Statistics as Topic
D001786:Blood Glucose; D007301:Insect Hormones; D007328:Insulin; D020738:Leptin; D009842:Oligopeptides; D052243:Resistin; C044833:adipokinetic hormone; D002097:C-Reactive Protein; D011761:Pyrrolidonecarboxylic Acid