Abstract

CAMINITI, Carolina et al. Obstructive sleep apneas in symptomatic obese children: polisomnographic confirmation and its association with disturbances in carbohydrate metabolism. Arch. argent. pediatr. [online]. 2010, vol.108, n.3, pp.226-233. ISSN 0325-0075.

Introduction. It has been shown that obesity is a risk factor for Obstructive Sleep Apneas (OSA) and that it could be related to insulin resistance (IR). Objective. To establish the frequency of OSA in obese children and adolescents with suggestive symptoms of sleep disordered breathing (SDB) by polisomnografic study (PSG) and to clinically characterize the groups with and without OSA, and their association with IR. Patients, material and methods. Descriptive, retrospective, cross-sectional study in patients with obesity and symptoms of SDB examined in the Hospital Nacional de Pediatría "Prof. Dr. Juan P. Garrahan" between october/2002 and july/2008 to whom PGS had been done. Anthropometric and oral glucose tolerance test data were obtained and indices of insulin resistance derived from the homeostatic model were calculated. We assessed the presence of OSA defined as apnea-hypopnea Index ≥ 1 Student's and Chi Square Tests were used, establishing a level of significance of 0.05. Results. A total of 58 children were studied (59%M), average age 8.8 ± 3.5 and Score Z-IMC 2.8 ± 0.7. In 55.2% of cases, OSA was confirmed, independently of the degree of obesity. 56.9% presented IR. The patients were divided in groups according to the presence or not of OSA. There were no significant differences in age nor in Score Z-IMC. The patients with OSA presented greater frequency of tonsil hypertrophy (p= 0.01, OR= 6.86) and IR (p= 0.01, OR= 4,44) and less insulin sensitivity (p= 0.04). Conclusions. Both IR and the presence of tonsil hypertrophy were predictors of OSA. This population seems to be heterogeneous. We underline the importance to look for SDB related signs and symptoms in patients with obesity of any degree.

Keywords : OSA; Central apnea; Childhood obesity; Insulin resistance.

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