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- Title
Weight Loss and Sleep-Disordered Breathing in Childhood Obesity: Effects on Inflammation and Uric Acid.
- Authors
Van Hoorenbeeck, Kim; Franckx, Hilde; Debode, Patrick; Aerts, Petra; Wouters, Kristien; Ramet, Jose; Van Gaal, Luc F.; Desager, Kristine N.; De Backer, Wilfried A.; Verhulst, Stijn L.
- Abstract
Sleep-disordered breathing (SDB) is prevalent in childhood obesity. It may be an independent risk factor for the metabolic syndrome. Possible mechanisms are inflammation and oxidative stress. Adenotonsillectomy in childhood obesity is associated with a high recurrence rate and risk of postoperative weight gain. Therefore, this study assessed the effects of SDB on inflammation and oxidative stress in childhood obesity before and after weight loss. We included 132 obese subjects between 10 and 18 years consecutively. Median age was 15.4 years (10.1-18.0). Mean BMI z-score was 2.72 ± 0.42. Leukocytes and differentiation, high sensitivity C-reactive protein (hs-CRP), and uric acid (UA) were determined at baseline and subjects underwent a sleep assessment. SDB was diagnosed in 39%. Linear regression analysis showed an association between UAlog and oxygen desaturation indexlog (ODIlog) (r = 0.20; P = 0.03), between leukocyteslog and respiratory disturbance indexlog (RDIlog) (r = 0.23; P = 0.01), and between lymphocyteslog and RDIlog (r = 0.19; P = 0.04). Follow-up was organized after 4-6 months of treatment. Median decrease in BMI z-score was 32%. Laboratory measurements were repeated. Subjects with SDB at baseline underwent a second sleep study. Of these 49 subjects, 12 showed residual SDB. This corresponds with a treatment success rate of 71%. Unlike changes in inflammatory markers, improvements in UA were associated with improvements in RDI and ODI (respectively: r = 0.44; P = 0.007, r = 0.41; P = 0.01). In conclusion, weight loss is effective in treating obese children with SDB. At baseline, a link exists between inflammation and SDB. Oxidative stress is reflected by UA at baseline and the concentration decreases after treatment according to improvements in SDB.
- Subjects
CHILDHOOD obesity; OVERWEIGHT children; WEIGHT loss; METABOLIC disorders in children; NUTRITION disorders in children; CHILDREN'S health; SLEEP disorders in children; SLEEP apnea syndromes in children
- Publication
Obesity (19307381), 2012, Vol 20, Issue 1, p172
- ISSN
1930-7381
- Publication type
Article
- DOI
10.1038/oby.2011.282