Metabolic changes in normal- and underweight children with obstructive sleep-disordered breathing.
OBJECTIVE
This study evaluates the metabolic profile of normal- and underweight children with sleep-disordered breathing (SDB) due to adenotonsillar hypertrophy.


METHODS
A total of 39 children aged 3-15 years with SDB and 28 age- and gender-matched controls were included in the study. Body mass index z score, blood pressure, and fasting serum levels of triglycerides (TGs), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol, very-low-density lipoprotein (VLDL), blood glucose, plasma insulin, and homeostatic model assessment (HOMA) were determined in both case patients and controls.


RESULTS
We observed significantly lower levels of fasting blood glucose (p = 0.015) and higher levels of HDL (p = 0.002), LDL (p = 0.002), and cholesterol (p = 0.001) in case patients than in controls. The mean values of fasting insulin and HOMA were higher in case patients (6.42 ± 6.47 and 1.40 ± 1.48) than in controls (5.31 ± 3.40 and 1.20 ± 0.84) respectively. No direct correlation between indices of severity of SDB and various metabolic and blood pressure parameters was found. When the effect of body weight was studied by subgrouping case patients according to normal weight and underweight, significant increases in the levels of fasting insulin (p = 0.039), HOMA (p = 0.017), and fasting blood glucose (p = 0.021) were observed. Also, a significant correlation was observed between the duration of illness and fasting insulin (p = 0.023), HOMA (p = 0.020), fasting glucose (p = 0.004), and diastolic blood pressure (p = 0.030).


CONCLUSIONS
This study shows an independent effect of body weight and duration of illness on various metabolic and blood pressure parameters in normal- and underweight children with SDB.
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Electronic address: docjcsuri@gmail.com.
Jagdish Chander
JC
Suri
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Manas Kamal
MK
Sen
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Rahul
R
Sharma
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Shibdas
S
Chakrabarti
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Elias
E
Mir
National Institute of Medical Statistics (Indian Council of Medical Research), Ansari Nagar, New Delhi, India.
Tulsi
T
Adhikari
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005215:Fasting / Q000378:metabolism; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood; D053419:Lipoproteins, IDL / Q000097:blood; D008297:Male; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000378:metabolism*; D013851:Thinness / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D008075:Lipoproteins, HDL; D053419:Lipoproteins, IDL; D014280:Triglycerides
Adenotonsillar enlargement; Insulin resistance; Metabolic changes; Normal and underweight children; Sleep-disordered breathing in children