Childhood obesity and obstructive sleep apnea.
Childhood obesity and obstructive sleep apnea.
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DOI：
10.1155/2012/134202
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发表时间：
2012
影响因子：
2.2
通讯作者：
Mathew JL
中科院分区：
文献类型：
--
作者：
Narang I;Mathew JL
儿童和青少年肥胖的全球流行及其对肥胖个人和整个社会的直接和长期后果怎么强调都不为过。儿童期和青春期肥胖与成人肥胖风险增加以及影响心血管和代谢系统的临床显著后果有关。重要的是，肥胖还会并发阻塞性睡眠呼吸暂停（OSA），高达60%的肥胖儿童会出现这种情况。阻塞性睡眠呼吸暂停（OSA）的诊断采用金标准多导睡眠图（PSG），其特征是打鼾，反复出现部分（呼吸不足）或完全（呼吸暂停）上呼吸道阻塞。阻塞性睡眠呼吸暂停常伴有间歇性血红蛋白氧饱和度过低、睡眠中断和睡眠破碎。越来越多的数据表明，OSA与心血管负担相关，包括全身性高血压、心室结构和功能改变、动脉僵硬和代谢综合征。因此，肥胖背景下的OSA可能会单独或协同地放大潜在的心血管和代谢负担。这一点很重要，因为肥胖儿童OSA的早期识别和治疗可能会减少肥胖儿童的心脏代谢负担。本文综述了肥胖相关OSA的研究现状。具体来说，本文将讨论肥胖儿童和青少年OSA的流行病学、病理生理学、心脏代谢负担和管理。
The global epidemic of childhood and adolescent obesity and its immediate as well as long-term consequences for obese individuals and society as a whole cannot be overemphasized. Obesity in childhood and adolescence is associated with an increased risk of adult obesity and clinically significant consequences affecting the cardiovascular and metabolic systems. Importantly, obesity is additionally complicated by obstructive sleep apnea (OSA), occurring in up to 60% of obese children. OSA, which is diagnosed using the gold standard polysomnogram (PSG), is characterised by snoring, recurrent partial (hypopneas) or complete (apneas) obstruction of the upper airway. OSA is frequently associated with intermittent oxyhemoglobin desaturations, sleep disruption, and sleep fragmentation. There is emerging data that OSA is associated with cardiovascular burden including systemic hypertension, changes in ventricular structure and function, arterial stiffness, and metabolic syndromes. Thus, OSA in the context of obesity may independently or synergistically magnify the underlying cardiovascular and metabolic burden. This is of importance as early recognition and treatment of OSA in obese children are likely to result in the reduction of cardiometabolic burden in obese children. This paper summarizes the current state of understanding of obesity-related OSA. Specifically, this paper will discuss epidemiology, pathophysiology, cardiometabolic burden, and management of obese children and adolescents with OSA.