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Are frequency and severity of sleep-disordered breathing in obese children and youth with and without type 2 diabetes mellitus different?

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Abstract

Obstructive sleep apnea (OSA) is a risk factor for insulin resistance and type 2 diabetes mellitus (T2DM) in adults. Data in children are limited. The aim was to study the frequency and severity of OSA and its association with cardiometabolic risk factors in obese children and adolescents with and without T2DM. In this prospective cross-sectional study, obese children and adolescents with and without T2DM underwent polysomnography and blood tests for fasting lipids, insulin, glucose, liver functions, and C-reactive protein. All participants completed a questionnaire on past and present sleep-disordered breathing (SDB). Results were compared between T2DM and obese non-diabetic controls matched for body mass index–standard deviation score (BMI–SDS) and also according to the glycemic status: T2DM, impaired glucose tolerance (IGT), and normal glycemic control. Eleven patients with T2DM (age 15.9 ± 3.6 years) and 30 BMI–SDS matched non-diabetic subjects (age 12.7 ± 3.0 years) were studied. Among the entire cohort, 45 % had a history of snoring, 26 % reported apneic episodes during sleep, and 65 % had daytime fatigue. There were no significant between-group differences in SDB history or abnormal polysomnographic results [apnea–hypopnea index (AHI) >5/h]. The percentage of subjects with AHI >5/h was 45.5 % in T2DM patients, 25 % in obese patients with IGT, and 18.2 % in obese patients without IGT, although the difference was not statistically significant (p = 0.25). Plasma C-reactive protein levels were related to both glycemic status and OSA severity. The severity of OSA in obese children and adolescents is unrelated to the presence of diabetes. OSA may play a minor role in the development and progression of T2DM in children and adolescents. Further studies in larger cohorts are required.

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Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights disclosure

All procedures followed were in accordance with the ethical standards of the local Institutional Ethics Review Board and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed consent disclosure

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel

    Joseph Meyerovitch

  2. Department of Pediatric Pulmonology, Critical Care and Sleep Medicine, Dana Children’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    Riva Tauman & Yakov Sivan

  3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Shlomit Shalitin, Riva Tauman, Joseph Meyerovitch & Yakov Sivan

  4. Jesse Z. and Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, 14 Kaplan Street, 49202, Petach Tikva, Israel

    Shlomit Shalitin

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  1. Shlomit Shalitin
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  2. Riva Tauman
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  4. Yakov Sivan
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Correspondence to Shlomit Shalitin.

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Managed by Antonio Secchi.

Shlomit Shalitin and Riva Tauman have equally contributed to this study.

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Shalitin, S., Tauman, R., Meyerovitch, J. et al. Are frequency and severity of sleep-disordered breathing in obese children and youth with and without type 2 diabetes mellitus different?. Acta Diabetol 51, 757–764 (2014). https://doi.org/10.1007/s00592-014-0583-1

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  • DOI: https://doi.org/10.1007/s00592-014-0583-1

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