Sleep-disordered breathing in adolescents with obesity: When does it start to affect cardiometabolic health?

Author(s):Show less -

Roche, Johanna ^{[1, 2, 3, 4]} ; Corgosinho, Flavia C. ^[5] ; Damaso, Ana R. ^[6] ; Isacco, Laurie ^[2] ; Miguet, Maud ^[1] ; Fillon, Alicia ^[1] ; Guyon, Aurore ^{[7, 8]} ; Moreira, Gustavo A. ^{[9, 6]} ; Pradella-Hallinan, Marcia ^{[9, 6]} ; Tufik, Sergio ^[9] ; de Mello, Marco Tulio ^[10] ; Gillet, Valerie ^[3] ; Pereira, Bruno ^[11] ; Duclos, Martine ^{[12, 13, 14, 15]} ; Boirie, Yves ^{[12, 13, 14, 16]} ; Masurier, Julie ^[17] ; Franco, Patricia ^{[7, 8]} ; Thivel, David ^{[12, 1]} ; Mougin, Fabienne ^[2]

Affiliation:Show less -

^[1] Clermont Auvergne Univ, Lab Metab Adaptat Exercise Physiol & Pathol Condi, UE3533, Clermont Ferrand - France

^[2] Univ Franche Comte, Exercise Performance Hlth Innovat Platform, EA3920, Besancon - France

^[3] Sleep & Hlth Med Ctr Ellipse, Franois - France

^[4] Univ Witwatersrand, Fac Hlth Sci, Sch Physiol, Wits Sleep Lab, Brain Funct Res Grp, 7 York Rd, ZA-2193 Johannesburg - South Africa

^[5] Univ Fed Goias, Fac Nutr, Programa Posgrad Nutr, Sao Paulo - Brazil

^[6] Univ Fed Sao Paulo, Programa Posgrad Nutr, Escola Paulista Med, Sao Paulo - Brazil

^[7] Lyon1 Univ, Woman Mother Child Hosp, Hosp Civils Lyon, Sleep Pediat Unit, F-69500 Lyon - France

^[8] Lyon1 Univ, Physiol Brain Arousal Syst Res Lab, CNRS, CRNL, INSERM, U1028, UMR5292, Lyon - France

^[9] Univ Fed Sao Paulo, Escola Paulista Med, Dept Psicobiol, Sao Paulo - Brazil

^[10] Univ Fed Minas Gerais, Programa Posgrad Educ Fis, Belo Horizonte, MG - Brazil

^[11] Clermont Ferrand Univ Hosp, Biostat Unit DRCI, Clermont Ferrand - France

^[12] CRNH Auvergne, Clermont Ferrand - France

^[13] Univ Clermont 1, UFR Med, Clermont Ferrand - France

^[14] INRA, UMR 1019, Clermont Ferrand - France

^[15] G Montpied Hosp, Clermont Ferrand Univ Hosp, Dept Sport Med & Funct Explorat, Clermont Ferrand - France

^[16] G Montpied Hosp, Clermont Ferrand Univ Hosp, Dept Human Nutr, Clermont Ferrand - France

^[17] UGECAM Nutr Obes Ambulatory Hosp, Clermont Ferrand - France

• Document type: Journal article
• Source: NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES; v. 30, n. 4, p. 683-693, APR 12 2020.
• Web of Science Citations: 0

Abstract

Background and aims: Pediatric obesity and sleep-disordered breathing (SDB) are associated with cardiometabolic risk (CMR), but the degree of severity at which SDB affects cardiometabolic health is unknown. We assessed the relationship between the CMR and the apneahypopnea index (AHI), to identify a threshold of AHI from which an increase in the CMR is observed, in adolescents with obesity. We also compared the clinical, cardiometabolic and sleep characteristics between adolescents presenting a high (CMR+) and low CMR (CMR-), according to the threshold of AHI. Methods and results: 114 adolescents with obesity were recruited from three institutions specialized in obesity management. Sleep and SDB as assessed by polysomnography, anthropometric parameters, fat mass (FM), glucose and lipid profiles, and blood pressure (BP) were measured at admission. Continuous (MetScore(FM)) and dichotomous (metabolic syndrome, MetS) CMR were determined. Associations between MetScore(FM) and AHI adjusted for BMI, sex and age were assessed by multivariable analyses. Data of 82 adolescents were analyzed. Multivariable analyses enabled us to identify a threshold of AHI = 2 above which we observed a strong and significant association between CMR and AHI (Cohen's d effect-size = 0.57 {[} 0.11; 1.02] p = 0.02). Adolescents with CMR+ exhibited higher MetScore(FM) (p < 0.05), insulin resistance (p < 0.05), systolic BP (p < 0.001), sleep fragmentation (p < 0.01) and intermittent hypoxia than CMR-group (p < 0.0001). MetS was found in 90.9% of adolescents with CMR+, versus 69.4% in the CMR-group (p < 0.05). Conclusions: The identification of a threshold of AHI >= 2 corresponding to the cardiometabolic alterations highlights the need for the early management of SDB and obesity in adolescents, to prevent cardiometabolic diseases. (C) 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved. (AU)

• FAPESP's process: 11/50414-0 - Influence of hyperleptinemia on inflammatory and atherogenic responses in obese adolescents
• Grantee: Ana Raimunda Dâmaso
• Support Opportunities: Regular Research Grants
• FAPESP's process: 13/04136-4 - Analysis of neuroendocrine regulation of balance energy and inflammatory factors in obese adults submitted to bariatric surgery
• Grantee: Ana Raimunda Dâmaso
• Support Opportunities: Regular Research Grants
• FAPESP's process: 06/00684-3 - Orexigenic, anorexigenic, pro and pre-inflamatory factors: effects of a multidisciplinary program for weight reduction in obese adolescents
• Grantee: Ana Raimunda Dâmaso
• Support Opportunities: Regular Research Grants