Obstructive sleep apnea (OSA) is associated with the impairment of beta-cell response to glucose in children and adolescents with obesity

• Published in: International Journal of Obesity 2023-04, Vol.47 (4), p.257-262
• Main Authors: Umano, Giuseppina Rosaria, Galderisi, Alfonso, Aiello, Francesca, Martino, Mariangela, Camponesco, Ornella, Di Sessa, Anna, Marzuillo, Pierluigi, Alfonso, Papparella, Miraglia del Giudice, Emanuele
• Format: Article
• Language: English
• Subjects: 692/163/2743/137; 692/163/2743/393; Adolescent; Adolescents; Apnea; Beta cells; Blood Glucose; Child; Children; Correlation; Desaturation; Epidemiology; Glucose; Glucose tolerance; Health Promotion and Disease Prevention; Homeostasis; Humans; Insulin; Insulin secretion; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Obesity; Pediatric Obesity - complications; Pediatric Obesity - epidemiology; Pediatrics; Polysomnography; Public Health; Secretion; Sensitivity; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Sleep disorders; Teenagers
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/s41366-023-01257-w

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