title: Glucose, insulin, and insulin resistance in normal-weight, overweight and obese children with obstructive sleep apnea.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is associated with components of metabolic syndrome. Both body weight and OSA independently influence metabolic measurements. The goal of this study was to determine whether OSA in normal-weight, overweight or obese children, compared to matched control groups, was associated with increased levels of glucose, insulin and insulin resistance (IR).
  
  
  METHODS
  Age- and gender-specific body mass index (BMI) percentiles were determined and used to categorize subjects into normal-weight (BMI<85%) and overweight-obese (BMI≥85%) groups. In addition, subjects were divided into normal-weight (BMI<85%), overweight (BMI≥85% and <95%) and obese (BMI≥95%) groups. Polysomnography was conducted and morning levels of glucose and insulin were measured and IR was determined from the blood samples collected early in the morning after overnight fast. Results were compared between the subject groups. Effects of severity of OSA defined by apnea hypopnea index (AHI) and oxygen desaturation index (ODI) on glucose, insulin, and HOMA-IR were analyzed.
  
  
  RESULTS
  Glucose, insulin, and HOMA-IR in OSA and matched control groups were not significantly different for normal-weight, overweight and obese subjects. The ODI was significantly associated with elevated levels of glucose and HOMA-IR after adjustment for age, gender, race, and BMI Z-score.
  
  
  CONCLUSIONS
  IR levels between OSA and control for both normal-weight, overweight and obese subjects were not significantly different. The ODI was associated with increased IR in children with OSA. OSA-induced hypoxic events during sleep may be a potential mechanism of increased IR in children with OSA, independent of body weight.
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States. Electronic address: Abu.Shamsuzzaman@CCHMC.ORG.
authors.forename: Abu
authors.initials: A
authors.lastname: Shamsuzzaman
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: Rhonda D
authors.initials: RD
authors.lastname: Szczesniak
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Fenchel
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
authors.forename: Raouf S
authors.initials: RS
authors.lastname: Amin
mesh_terms: D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006706:Homeostasis; D006801:Humans; D056865:Ideal Body Weight / Q000502:physiology*; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D050177:Overweight / Q000097:blood* / Q000150:complications; D063766:Pediatric Obesity / Q000097:blood* / Q000150:complications; D017286:Polysomnography; D012720:Severity of Illness Index; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000209:etiology
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Insulin resistance; Obesity; Sleep apnea