title: Sleep-disordered breathing is associated with blood pressure and carotid arterial stiffness in obese children.
abstract: Both sleep-disordered breathing (SDB) and high blood pressure (BP) occur more frequently among obese children than among normal weight children, and this may be due to endothelial dysfunction and worsened arterial stiffness. The aim of this study was to evaluate the possible association between SDB and BP, and the possible role of endothelial function and local and systemic arterial stiffness in a sample of obese children asymptomatic for sleep disturbances.
  
  
  
  Thirty-nine obese children were included in the study. Children underwent overnight limited channel polysomnography, and the vascular measurements included the following: office and 24-h ambulatory BP; brachial flow-mediated dilatation, carotid intima-media thickness and carotid distensibility measured using ultrasound; and systemic arterial stiffness index measured using digital volume pulse analysis.
  
  
  
  Significant correlations between different BP measurements (both office and ambulatory BP monitoring and estimated by Z score) and SDB were found, including correlations involving the respiratory disturbance index, the apnea-hypopnea index (AHI), the number of desaturations per hour and the mean peripheral saturation (r ranging between 0.330 and 0.474). Carotid distensibility was correlated with the AHI (r = -0.367; P = 0.030) and with the mean oxygen saturation (r = 0.401; P = 0.017). In contrast, there was no relationship among flow-mediated dilatation, stiffness index, carotid intima-media thickness and all the tested respiratory markers. In the multivariate analysis, the supine Z SBP remained independently associated with the number of desaturations per hour and the AHI, even after correction for carotid distensibility and BMI.
  
  
  
  Our data suggest that in obese children asymptomatic for sleep respiratory problems, SDB might worsen BP, in part, through an increase in arterial stiffness.
authors.affiliation: aDepartment of Medicine, Section of General Medicine and Hypertension bDepartment of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division cDepartment of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Tagetti
authors.forename: Sara
authors.initials: S
authors.lastname: Bonafini
authors.forename: Marco
authors.initials: M
authors.lastname: Zaffanello
authors.forename: Maria V
authors.initials: MV
authors.lastname: Benetti
authors.forename: Francesco Dalle
authors.initials: FD
authors.lastname: Vedove
authors.forename: Emma
authors.initials: E
authors.lastname: Gasperi
authors.forename: Paolo
authors.initials: P
authors.lastname: Cavarzere
authors.forename: Rossella
authors.initials: R
authors.lastname: Gaudino
authors.forename: Giorgio
authors.initials: G
authors.lastname: Piacentini
authors.forename: Pietro
authors.initials: P
authors.lastname: Minuz
authors.forename: Claudio
authors.initials: C
authors.lastname: Maffeis
authors.forename: Franco
authors.initials: F
authors.lastname: Antoniazzi
authors.forename: Cristiano
authors.initials: C
authors.lastname: Fava
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D002648:Child; D004727:Endothelium / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D059289:Vascular Stiffness; D014664:Vasodilation
chemical_list: D010100:Oxygen