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Increased systemic inflammation overnight correlates with insulin resistance among children evaluated for obstructive sleep apnea

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Abstract

Purpose

Obstructive sleep apnea (OSA) in children is associated with obesity, insulin resistance, and elevated baseline inflammation as measured by high-sensitivity C-reactive protein (hsCRP). Our goal was to evaluate whether inflammation increases overnight among children suspected of having OSA and to determine whether worsened inflammation is associated with the degree of OSA severity, obesity, and/or insulin resistance.

Methods

Twenty-three children with clinical suspicion of OSA underwent a sleep study. Levels of hsCRP were tested the evening before and morning after the sleep study. Fasting insulin and glucose levels were measured from which the homeostasis model of insulin resistance (HOMA-IR) was calculated. Linear correlations were performed to evaluate relationships between hsCRP levels at baseline and change overnight (ΔhsCRP) vs. HOMA-IR, body mass index (BMI) z-score, and sleep study parameters related to O2 saturation and the apnea-hypopnea index (AHI).

Results

Among children with OSA and the entire cohort, hsCRP values were correlated with HOMA-IR and BMI z-scores. HOMA-IR but not BMI z-score correlated with ΔhsCRP overnight in the entire cohort. Sleep study parameters, including AHI mean O2 saturation overnight, REM O2 nadir, and non-REM O2 nadir were not correlated with hsCRP or ΔhsCRP overnight.

Conclusion

Among children being evaluated for OSA, degree of insulin resistance may be an important determinant of increased systemic inflammation overnight. Sleep study markers did not correlate with ΔhsCRP, leaving uncertain the role of OSA in increasing inflammation overnight. Further studies are needed to explore these associations and their potential mechanisms.

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Acknowledgments

University of Virginia Children’s Hospital Grant-in-Aid

NIH 5K08HD060739-02, 5R01HL059337-11, 5R01NS054117-04, 5M01RR000847-37

Conflict of interest

The authors report that they have no conflicts of interest pertaining to this study.

Author information

Authors and Affiliations

  1. Division of Pediatric Endocrinology, P.O. Box 800386, Charlottesville, VA, 22908, USA

    Mark D. DeBoer

  2. Division of Pulmonary Medicine, P.O. Box 800386, Charlottesville, VA, 22908, USA

    James P. Mendoza, Gabriele Ford, Pearl L. Yu & Benjamin M. Gaston

  3. Department of Public Health Sciences, P.O. Box 800386, Charlottesville, VA, 22908, USA

    Lei Liu, Gabriele Ford, Pearl L. Yu & Benjamin M. Gaston

  4. University of Virginia, P.O. Box 800386, Charlottesville, VA, 22908, USA

    Mark D. DeBoer, James P. Mendoza & Lei Liu

Authors
  1. Mark D. DeBoer
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  2. James P. Mendoza
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  3. Lei Liu
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  4. Gabriele Ford
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  5. Pearl L. Yu
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  6. Benjamin M. Gaston
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Corresponding author

Correspondence to Mark D. DeBoer.

Electronic supplementary material

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Supplementary Table 1

Linear correlations related to baseline hsCRP, ΔhsCRP, and sleep study indices (DOC 41 kb)

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DeBoer, M.D., Mendoza, J.P., Liu, L. et al. Increased systemic inflammation overnight correlates with insulin resistance among children evaluated for obstructive sleep apnea. Sleep Breath 16, 349–354 (2012). https://doi.org/10.1007/s11325-011-0499-8

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  • DOI: https://doi.org/10.1007/s11325-011-0499-8

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