Key result
Moderate and severe obstructive sleep apnea was associated with a 6.2-fold higher odds of elevated 1-hour plasma glucose compared to mild OSA in children and adolescents with obesity.
Why the study?
The study was conducted to assess the association between obstructive sleep apnea and insulin secretion in children with obesity.
Is moderate to severe obstructive sleep apnea associated with impaired insulin secretion and glucose homeostasis in children and adolescents with obesity compared to mild OSA?
Cross-Sectional (n=77)
No
Is moderate to severe obstructive sleep apnea associated with impaired insulin secretion and glucose homeostasis in children and adolescents with obesity compared to mild OSA?
Odds Ratio: 6.2 (95% CI 1.6–23.4)
p-value: p=0.007
Moderate to severe obstructive sleep apnea in children and adolescents with obesity is associated with impaired beta-cell function and reduced insulin secretion compared to mild OSA.
OSA severity may flag higher glucose dysregulation risk in obese youth; leaves open prospective confirmation of causality and treatment effects.
BACKGROUND: The main purpose of the study is to assess the association between obstructive sleep apnea (OSA) and insulin secretion in children with obesity. METHODS: We enrolled children and adolescents who attended our pediatric clinic because of obesity and OSA. Glucose homeostasis was assessed through standard 2-h oral glucose tolerance test (OGTT). Nocturnal cardio-respiratory polygraphy was performed for OSA diagnosis. Twenty-two patients underwent a 3-h OGTT to investigate insulin secretion and sensitivity through the oral-minimal model. RESULTS: seventy-seven children and adolescents were included in the study. Based on OSA severity, the cohort was divided into three groups (29 mild, 29 moderate, and 19 severe OSA). The group with mild OSA showed lower levels of 30-min glucose (p = 0.01) and 60-min glucose (p = 0.03), and lower prevalence of elevated 1-h glucose (10.4% versus 44.8% in moderate and 31.6% in severe OSA, p = 0.01). The odds for elevated 1-h plasma glucose was 6.2-fold (95%CI 1.6-23.4) higher in subjects with moderate and severe OSA compared to mild OSA (p = 0.007) independent of confounders. Spearman correlation test revealed a positive correlation between 30-min plasma glucose and apnea-hypopnea index (AHI, r = 0.31, p = 0.01), oxygen desaturation index (ODI, r = 0.31, p = 0.009), and mean desaturation (r = 0.25, p = 0.04). The 3-h OGTT study included 22 participants (7 mild, 9 moderate, and 6 severe OSA). The group with mild OSA showed a higher dynamic, static, and total insulin secretion compared to those with moderate and severe OSA (p < 0.0001, p = 0.007, p = 0.007, respectively). AHI was significantly correlated to dynamic insulin secretion (r = -0.48, p = 0.02). CONCLUSIONS: OSA might impair beta-cell function reducing the pool of promptly releasable insulin in children and adolescents with obesity, in the absence of an effect on insulin sensitivity.
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Umano et al. (2023) conducted a cross-sectional in Obesity and obstructive sleep apnea (n=77). Moderate and severe obstructive sleep apnea vs. Mild obstructive sleep apnea was evaluated on Elevated 1-hour plasma glucose (OR 6.2, 95% CI 1.6-23.4, p=0.007). Moderate and severe obstructive sleep apnea was associated with a 6.2-fold higher odds of elevated 1-hour plasma glucose compared to mild OSA in children and adolescents with obesity.
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