Oxidative stress in obese children and adolescents with and without type 2 diabetes mellitus is not associated with obstructive sleep apnea
- 107 Downloads
Obesity, obstructive sleep apnea (OSA), and type 2 diabetes mellitus (T2DM) are associated with chronic low-grade inflammation and oxidative stress. In adults, increased lipid peroxidation, a marker of oxidative stress, was found in both metabolic syndrome and OSA. Studies on oxidative stress in children with T2DM and OSA are scarce.
Plasma oxidized low-density lipoprotein (Ox-LDL) levels were evaluated in obese children and adolescents with/without T2DM, and the contribution of OSA to oxidative stress was investigated.
Ten patients with T2DM, 8 with impaired glucose tolerance (IGT), and 20 body mass index-standard deviation score (BMI-SDS)-matched non-diabetic children (controls) were studied. They all underwent overnight polysomnography. Fasting plasma concentrations of Ox-LDL were measured and compared to the glycemic status and to the presence of OSA. Fourteen patients (36%) were diagnosed with OSA and 21 (55%) with hypertension. There were no significant group differences in plasma Ox-LDL levels or between patients with/without OSA. Plasma Ox-LDL levels were significantly higher among patients with hypertension compared to controls (P = 0.01), while they correlated with homeostasis model assessment (P = 0.02), BMI-SDS (P = 0.049), and systolic blood pressure (P = 0.002).
The findings of this pilot study suggest that increased lipid peroxidation is associated with insulin resistance and hypertension in obese children and adolescents, while OSA has most likely minor influence.
KeywordsInsulin resistance Type 2 diabetes mellitus Obesity Obstructive sleep apnea Ox-LDL
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional research committee (Schneider Children’s Medical Center of Israel and the Tel Aviv Souraski Medical Center) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 4.Singer K, Eng DS, Lumeng CN, Gebremariam A, M Lee J (2014) The relationship between body fat mass percentiles and inflammation in children. Obesity 22(5):1332–1336Google Scholar
- 7.Tan HL, Gozal D, Kheirandish-Gozal L (2013) Obstructive sleep apnea in children: a critical update. Nat Sci Sleep 25(5):109–123Google Scholar
- 11.Lavie L, Vishnevsky A, Lavie P (2004) Evidence for lipid peroxidation in obstructive sleep apnea. Sleep 27(1):123–128Google Scholar
- 19.Holvoet P, Lee DH, Steffes M, Gross M, Jacobs DR Jr. (2008) Association between circulating oxidized low-density lipoprotein and incidence of the metabolic syndrome. JAMA 299(19):2287–2293Google Scholar
- 21.Norris AL1, Steinberger J, Steffen LM, Metzig AM, Schwarzenberg SJ, Kelly AS (2011). Circulating oxidized LDL and inflammation in extreme pediatric obesity. Obesity 19(7):1415–1419Google Scholar
- 22.Kelly AS, Jacobs DR, Jr, Sinaiko AR, Moran A, Steffen LM, Steinberger J (2010) Relation of circulating oxidized LDL to obesity and insulin resistance in children. Pediatr Diabetes11(8):552–555Google Scholar
- 23.Tauman R, Lavie L, Greenfeld M, Sivan Y (2014) Oxidative stress in children with obstructive sleep apnea syndrome. J Clin Sleep Med 10(6):677–681Google Scholar
- 25.Shalitin S, Deutsch V, Tauman R (2018) Hepcidine, soluble transferrin receptor and IL-6 levels in obese children and adolescents with and without type 2 diabetes mellitus/impaired glucose tolerance and their association with obstructive sleep apnea. J Endocrinol Invest (pubmed ahead of print)Google Scholar
- 28.Iber C, Ancoli-Israel S, Chesson A, Quan SF (2007) For the American Academy of sleep medicine rules, terminology and technical specifications, 1st edn. American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events, Westchester ILGoogle Scholar
- 30.James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E (2014) Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 311:507–520CrossRefGoogle Scholar