Association of visceral adiposity and systemic inflammation with sleep disordered breathing in normal weight, never obese adolescents
Association of visceral adiposity and systemic inflammation with sleep disordered breathing in normal weight, never obese adolescents
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DOI：
10.1016/j.sleep.2020.01.011
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发表时间：
2020-05-01
期刊：
影响因子：
4.8
通讯作者：
Bixler, Edward O.
中科院分区：
文献类型：
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作者：
Danisi, Jacqueline M.;Fernandez-Mendoza, Julio;Bixler, Edward O.
目的/背景：虽然肥胖是睡眠呼吸障碍（SDB）的已知危险因素，但根据体重指数百分位数（BMI%）标准，很大一部分患有SDB的儿童并不超重。本研究旨在探讨正常体重青年的病前或并发肥胖表型和炎症是否与SDB相关。患者/方法：共有242名来自宾夕法尼亚州立大学儿童队列（PSCC, N = 421，基线时5-12岁，随访时12-23岁）的持续非超重（BMI%< 85）受试者被研究。在两个时间点通过多导睡眠图（PSG）确定呼吸暂停/低通气指数（AHI）。在随访中，双能x线吸收仪（DXA）扫描评估android和gynoid分布以及皮下（SAT）和内脏（VAT）脂肪组成，同时空腹抽血检测c反应蛋白（CRP）和白细胞介素-6 （IL-6）水平。以随访AHI为主要结局的多变量线性回归模型，根据性别、种族、腺扁桃体切除术、年龄和基线AHI进行调整。结果和结论：基线腰围增加（β = 0.227, p = 0.001）与随访时较高的AHI显著相关，但与BMI%、颈围或臀围无关。随访时VAT （beta = 0.309, p < 0.001）、IL-6 （beta = 0.243, p < 0.001）、SAT （beta = 0.235, p = 0.013）、CRP （beta = 0.221, p = 0.001）和android分布（beta = 0.196, p = 0.003）与随访时较高的AHI显著相关。儿童期中枢性肥胖预示着青春期的SDB，即使是那些根据BMI标准从童年开始就从未超重过的人。内脏脂肪和炎症与青少年SDB同时发生，这支持了这些生物标志物在预测其相关心脏代谢风险方面的临床应用。(C) 2020 Elsevier B.V.版权所有
Objective/background: While obesity is a known risk factor for sleep disordered breathing (SDB), a large proportion of children with SDB are not overweight as per body mass index percentile (BMI%) criteria. This study aimed to examine whether premorbid or concurrent adiposity phenotypes and inflammation are associated with SDB in normal weight youth.Patients/methods: A total of 242 persistently non-overweight (BMI%< 85) subjects from the Penn State Child Cohort (PSCC, N = 421, 5-12 y at baseline and 12-23 y at follow-up), were studied. The apnea/hypopnea index (AHI) was ascertained via polysomnography (PSG) at both time points. At follow-up, a dual-energy X-ray absorptiometry (DXA) scan assessed android and gynoid distribution and subcutaneous (SAT) and visceral (VAT) adiposity composition, while a fasting blood draw was assayed for C-reactive protein (CRP) and interleukin-6 (IL-6) levels. Multivariable linear regression models with AHI at follow-up as primary outcome were adjusted for sex, race, adenotonsillectomy, age and AHI at baseline.Results and conclusions: Increased waist circumference (beta = 0.227, p = 0.001) at baseline, but not BMI%, neck or hip circumference, was significantly associated with a higher AHI at follow-up. VAT (beta = 0.309, p < 0.001), IL-6 (beta = 0.243, p < 0.001), SAT (beta = 0.235, p = 0.013), CRP (beta = 0.221, p = 0.001), and an android distribution (beta = 0.196, p = 0.003) at follow-up were significantly associated with a higher AHI at follow-up. Childhood central adiposity predicts SDB in adolescence, even in individuals who have never been overweight since childhood as per BMI criteria. Visceral adiposity and inflammation are concurrent to adolescent SDB, which supports the clinical utility of these biomarkers in predicting its associated cardiometabolic risk. (C) 2020 Elsevier B.V. All rights reserved.