Identifying Pathways Mediating Obstructive Sleep Apnea and Obesity in Indian Children

Abstract

Objective: Overweight and obesity in children is associated with several metabolic and cardiovascular impairments, including obstructive sleep apnea (OSA). However, the causal pathway from OSA to obesity is not fully known yet. The aim of this study was to explore the association between OSA and obesity-related metabolic outcomes in obese Indian children. Methods: An observational, cross-sectional study was conducted. Obese children referred to the Otorhinolaryngology Department at the Maulana Azad Medical College (New Delhi, India) for suspicion of OSA were consecutively enrolled. OSA was diagnosed by polysomnographic parameters. Homeostasis model assessment (HOMA) was calculated to measure insulin sensitivity and HOMA > 4.39 was considered as a threshold for insulin resistance. The association between various polysomnographic measures and HOMA, adiponectin and various urinary catecholamines was assessed. Results: Complete polysomnographic parameters were available for 45 children; of these 29 were found to suffer from OSA. OSA children had significantly higher glucose concentrations compared to non-OSA ones (p value = 0.012) but no differences were found in insulin resistance and urinary catecholamines levels. Older age was significantly associated to lower levels of catecholamines. No significant associations were found between polysomnographic parameters and both HOMA and adiponectin. Only age was found to be significantly associated with HOMA (p = 0.03) and adiponectin (p = 0.01). Conclusions: A better understanding of the role played by OSA on obese children’s metabolic functions is crucial to implement specific prevention strategies to reduce the public health burden of non-communicable diseases.