Sleep fragmentation and intermittent hypoxemia are associated with decreased insulin sensitivity in obese adolescent Latino males.
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 was used to assess glucose homeostasis. Total-body dual-energy X-ray absorptiometry was used to quantify adiposity.


RESULTS
A total of 22 males (mean age ± SD: 13.4 ± 2.1 y, BMI z-score 2.4 ± 0.3, obstructive apnea hypopnea index 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 (S(G), the capacity of glucose to mediate its own disposal). The Log total arousal index was positively correlated with Log homeostasis model assessment-estimated insulin resistance.


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.
Division of Pediatric Pulmonology, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
Daniel J
DJ
Lesser
Rajeev
R
Bhatia
Winston H
WH
Tran
Flavia
F
Oliveira
Ricardo
R
Ortega
Thomas G
TG
Keens
Steven D
SD
Mittelman
Michael C K
MC
Khoo
Sally L
SL
Davidson Ward
D000293:Adolescent; D002648:Child; D006630:Hispanic or Latino; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000503:physiopathology*