Sleep and Breathing

, Volume 22, Issue 1, pp 205–210 | Cite as

Glycated hemoglobin and sleep apnea syndrome in children: beyond the apnea–hypopnea index

  • J. A. Peña-Zarza
  • M. De la Peña
  • A. Yañez
  • J. M. Bauça
  • D. Morell-Garcia
  • M. Caimari
  • A. Barceló
  • J. Figuerola
Pediatrics • Original Article



Snoring and obstructive sleep apnea syndrome (OSA) are frequent conditions in pediatrics. Glycated hemoglobin (HbA1C) is a useful homeostatic biomarker of glycemia and may reflect alterations deriving from sleep breathing disorders. The aim of this study was to relate the severity of OSA with blood HbA1C levels in children.


A descriptive observational study in snoring patients was performed. All patients underwent a sleep study and classified either as simple snorers (apnea–hypopnea index; AHI ≤ 1 episodies/h) or as OSA patients (AHI > 1 episodes/h). In the following morning, a blood glycemic profile (fasting glucose, insulin, HbA1C, and the HOMA index) was performed to every individual.


A total of 48 patients were included. HbA1C levels were shown to be increased in the moderate OSA (AHI > 5 episodes/h) group (5.05 ± 0.25 vs. 5.24 ± 0.29%; p = 0.019). Significant correlations were found between HbA1C values and AHI (r = 0.345; p = 0.016) and also with oxygen desaturation index (r = 0.40; p = 0.005). Correlations remained significant after adjusting by age and body mass index. The AHI-associated change in HbA1C was 13.4% (p = 0.011).


In the pediatric population, HbA1C is a biomarker associated with OSA severity, and this relationship is age- and obesity-independent. The fact that this association was observed in snoring patients could help the physician in the distinction between those patients affected with OSA and those with simple snoring. Therefore, HbA1C measurement could play a major role in the diagnosis and the management of the syndrome.


Snoring Sleep apnea Sleep disorder breathing Glycated hemoglobin Pediatric sleep disorder 


Author contributions

JAPZ, AB, JMB, DMG, and MP conceived and designed the study. JAPZ, AB, DMG, and AY supervised the data collection and managed the data, including quality control. JAPZ, AB, DMG, and AY provided statistical advice on study design and analyzed the data; AB and MP chaired the data oversight committee. JAPZ, MP, AB, DMG, and JMB drafted the manuscript, and all authors contributed substantially to its revision. JAPZ, AB, MC, and JF take responsibility for the paper as a whole.

Compliance with ethical standards

A funding statement

This work was supported by Fondo de Investigación Sanitaria [Grant: FIS PI1302120]. The sponsor had no role in the design or conduct of this research.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Previous presetation in a meeting

The manuscript content has not been presented elsewhere.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • J. A. Peña-Zarza
    • 1
  • M. De la Peña
    • 2
  • A. Yañez
    • 3
  • J. M. Bauça
    • 3
    • 4
  • D. Morell-Garcia
    • 3
    • 4
  • M. Caimari
    • 5
  • A. Barceló
    • 3
    • 4
  • J. Figuerola
    • 1
  1. 1.Pulmonology and Sleep Disorders Section, Department of PediatricsHospital Universitari Son EspasesPalma de MallorcaSpain
  2. 2.Respiratory DepartmentHospital Universitari Son EspasesPalma de MallorcaSpain
  3. 3.Institut d’Investigació Sanitària de Palma (IdISPa)Palma de MallorcaSpain
  4. 4.Department of Laboratory MedicineHospital Universitari Son EspasesPalma de MallorcaSpain
  5. 5.Endocrinology Section, Department of PediatricsHospital Universitari Son EspasesPalma de MallorcaSpain

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