title: Are frequency and severity of sleep-disordered breathing in obese children and youth with and without type 2 diabetes mellitus different?
abstract: Obstructive sleep apnea (OSA) is a risk factor for insulin resistance and type 2 diabetes mellitus (T2DM) in adults. Data in children are limited. The aim was to study the frequency and severity of OSA and its association with cardiometabolic risk factors in obese children and adolescents with and without T2DM. In this prospective cross-sectional study, obese children and adolescents with and without T2DM underwent polysomnography and blood tests for fasting lipids, insulin, glucose, liver functions, and C-reactive protein. All participants completed a questionnaire on past and present sleep-disordered breathing (SDB). Results were compared between T2DM and obese non-diabetic controls matched for body mass index-standard deviation score (BMI-SDS) and also according to the glycemic status: T2DM, impaired glucose tolerance (IGT), and normal glycemic control. Eleven patients with T2DM (age 15.9 ± 3.6 years) and 30 BMI-SDS matched non-diabetic subjects (age 12.7 ± 3.0 years) were studied. Among the entire cohort, 45 % had a history of snoring, 26 % reported apneic episodes during sleep, and 65 % had daytime fatigue. There were no significant between-group differences in SDB history or abnormal polysomnographic results [apnea-hypopnea index (AHI) >5/h]. The percentage of subjects with AHI >5/h was 45.5 % in T2DM patients, 25 % in obese patients with IGT, and 18.2 % in obese patients without IGT, although the difference was not statistically significant (p = 0.25). Plasma C-reactive protein levels were related to both glycemic status and OSA severity. The severity of OSA in obese children and adolescents is unrelated to the presence of diabetes. OSA may play a minor role in the development and progression of T2DM in children and adolescents. Further studies in larger cohorts are required.
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, shalitin@netvision.net.il.
authors.forename: Shlomit
authors.initials: S
authors.lastname: Shalitin
authors.forename: Riva
authors.initials: R
authors.lastname: Tauman
authors.forename: Joseph
authors.initials: J
authors.lastname: Meyerovitch
authors.forename: Yakov
authors.initials: Y
authors.lastname: Sivan
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein