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22.01.2018 | Sleep Breathing Physiology and Disorders • Original Article

Intermittent nocturnal hypoxia and metabolic risk in obese adolescents with obstructive sleep apnea

verfasst von: Indra Narang, Brian W. McCrindle, Cedric Manlhiot, Zihang Lu, Suhail Al-Saleh, Catherine S. Birken, Jill Hamilton

Erschienen in: Sleep and Breathing | Ausgabe 4/2018

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Abstract

Purpose

There is conflicting data regarding the independent associations of obstructive sleep apnea (OSA) with metabolic risk in obese youth. Previous studies have not consistently addressed central adiposity, specifically elevated waist to height ratio (WHtR), which is associated with metabolic risk independent of body mass index.

Objective

The objective of this study was to determine the independent effects of the obstructive apnea-hypopnea index (OAHI) and associated indices of nocturnal hypoxia on metabolic function in obese youth after adjusting for WHtR.

Methods

Subjects had standardized anthropometric measurements. Fasting blood included insulin, glucose, glycated hemoglobin, alanine transferase, and aspartate transaminase. Insulin resistance was quantified with the homeostatic model assessment. Overnight polysomnography determined the OAHI and nocturnal oxygenation indices.

Results

Of the 75 recruited subjects, 23% were diagnosed with OSA. Adjusting for age, gender, and WHtR in multivariable linear regression models, a higher oxygen desaturation index was associated with a higher fasting insulin (coefficient [standard error] = 48.076 [11.255], p < 0.001), higher glycated hemoglobin (coefficient [standard error] = 0.097 [0.041], p = 0.02), higher insulin resistance (coefficient [standard error] = 1.516 [0.364], p < 0.001), elevated alanine transferase (coefficient [standard error] = 11.631 [2.770], p < 0.001), and aspartate transaminase (coefficient [standard error] = 4.880 [1.444], p = 0.001). However, there were no significant associations between OAHI, glucose metabolism, and liver enzymes.

Conclusion

Intermittent nocturnal hypoxia rather than the OAHI was associated with metabolic risk in obese youth after adjusting for WHtR. Measures of abdominal adiposity such as WHtR should be considered in future studies that evaluate the impact of OSA on metabolic health.

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Titel: Intermittent nocturnal hypoxia and metabolic risk in obese adolescents with obstructive sleep apnea
verfasst von: Indra Narang
Brian W. McCrindle
Cedric Manlhiot
Zihang Lu
Suhail Al-Saleh
Catherine S. Birken
Jill Hamilton
Publikationsdatum: 22.01.2018
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 4/2018
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-018-1631-9

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