title: Metabolic disregulation in obese adolescents with sleep-disordered breathing before and after weight loss.
abstract: OBJECTIVE
  Sleep-disordered breathing (SDB) is prevalent in obesity. Weight loss is one of the most effective treatment options. The aim was to assess the association of SDB and metabolic disruption before and after weight loss.
  
  
  METHODS
  Obese adolescents were included when entering an in-patient weight loss program. Fasting blood analysis was performed at baseline and after 4-6 months. Sleep screening was done at baseline and at follow-up in case of baseline SDB.
  
  
  RESULTS
  224 obese adolescents were included. Median age was 15.5 years (10.1-18.0) and mean BMI z-score was 2.74 ± 0.42. About 30% had SDB at baseline (N = 68). High-density lipoprotein (HDL)-cholesterol was associated with mean nocturnal oxygen saturation (<SaO2>) (partial r = 0.21; P = 0.002). Aspartate aminotransferase (ASAT) and alanine aminotransferase were related with oxygen desaturation index (partial r = -0.15; P = 0.03 and partial r = -0.15; P = 0.02), but this became insignificant after correction for sex. After weight loss, 24% had residual SDB. Linear regression showed an association between ASAT and <SaO2> (partial r = -0.34; P = 0.002). There were no significant correlations between improvements in laboratory measurements and sleep parameters. HDL-cholesterol improved in relation with the decrease in BMI z-score.
  
  
  CONCLUSIONS
  SDB at baseline was associated with higher levels of liver enzymes and lower HDL-cholesterol concentration. Improvements in sleep parameters were not associated with improvements in laboratory measurements.
authors: Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium. kim.vanhoorenbeeck@ua.ac.be
authors: K
authors: K
authors: Van Hoorenbeeck
authors: H
authors: H
authors: Franckx
authors: P
authors: P
authors: Debode
authors: P
authors: P
authors: Aerts
authors: J
authors: J
authors: Ramet
authors: L F
authors: LF
authors: Van Gaal
authors: K N
authors: KN
authors: Desager
authors: W A
authors: WA
authors: De Backer
authors: S L
authors: SL
authors: Verhulst
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D006801:Humans; D016014:Linear Models; D009765:Obesity / Q000503:physiopathology* / Q000628:therapy; D015995:Prevalence; D012891:Sleep Apnea Syndromes / Q000503:physiopathology* / Q000628:therapy; D015431:Weight Loss
chemical_list: D008076:Cholesterol, HDL; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase