Catecholamines, adiponectin, and insulin resistance as measured by HOMA in children with obstructive sleep apnea
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INTRODUCTION: Obstructive sleep apnea (OSA) has been implicated in the pathophysiology of metabolic syndrome. Its contribution to insulin resistance is complicated by obesity and puberty. We hypothesized that OSA is associated with worse insulin resistance and lower adiponectin after adjustment for obesity and puberty and that catecholamines might mediate these changes. METHODS: Normal controls and children with suspected OSA were recruited and categorized as pubertal or prepubertal. Overnight polysomnography (PSG) was performed. Subjects were categorized as OSA for total apnea hypopnea index (Total-AHI) > or = 1.5 events/h. Fasting blood glucose, insulin, adiponectin, and 24-hour urinary catecholamines were obtained. Homeostatic model assessment of insulin resistance (HOMA) was calculated. The independent effects of OSA upon HOMA, adiponectin, and urinary catecholamines following adjustment for body mass index (BMI) were determined. RESULTS (median; min, max): Subjects (n = 98, 42F; 11 +/- 4 years, 37 prepubertal) were generally overweight (BMI-Z = 2.1; -3, 4.1) and had wide-ranging insulin sensitivities (HOMA = 2.7; 0.5, 27) and PSG parameters (Total-AHI = 1.6; 0, 185). The risks of elevated insulin (P = 0.04) and HOMA (P = 0.05) were higher in OSA vs non OSA obese pubertal children. Polysomnographic markers of OSA, including Total-AHI (P = 0.001, R2 = 0.32), were negatively associated with adiponectin in pubertal children. Total-AHI and oxygen desaturation were associated with higher urinary normetanephrine and norepinephrine. CONCLUSIONS: In obese pubertal children, OSA was associated with worse insulin resistance. Worsening OSA was associated with lower adiponectin and increasing urinary catecholamines. Whether OSA directly lowers adiponectin and aggravates a predisposition to insulin resistance is unknown, but these preliminary findings highlight the importance of further studying pediatric OSA.
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OSA has been associated with insulin resistance in children.
“OSA has been associated with T2DM risk in adults (10) and with IR in children (11,12).”
From Sleep architecture and glucose and insulin homeostasis in obese adolescents (2011) · cites this paper as [12]
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Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome
Marcus, C. L., Brooks, L. J., Draper, K. A., Gozal, D., Halbower, A. C., Jones, J., Schechter, M. S., Sheldon, S. H., Spruyt, K., Ward, S. D., et al. (2012) · Pediatrics · doi:10.1542/peds.2012-1671 · Cited by 2,432 · see citing works
Self-citationSleep architecture and glucose and insulin homeostasis in obese adolescents
Koren, D., Levitt Katz, L. E., Brar, P. C., Gallagher, P. R., Berkowitz, R. I., & Brooks, L. J. (2011) · Diabetes Care · doi:10.2337/dc11-1093 · Cited by 134 · see citing works
“OSA has been associated with T2DM risk in adults (10) and with IR in children (11,12).”
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- Authors
- Kelly, A., Dougherty, S., Cucchiara, A., Marcus, C. L., & Brooks, L. J.
- Affiliations
- Children's Hospital of Philadelphia (US)
- University of Pennsylvania (US)
- Venue
- SLEEP
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-09
- Volume
- 33
- Issue
- 9
- Pages
- 1185-1191
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2938859
- OpenAlex
- W1645133673
- Cited by
- 85
- References
- 65
- Citations by year
- 2025: 1 · 2024: 6 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 8 · 2017: 4 · 2016: 6 · 2015: 9 · 2014: 10 · 2013: 8 · 2012: 9
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k23rr021973-05)
- National Heart, Lung, and Blood Institute (R01HL058585, R56HL058585, HL-58585)
- National Center for Research Resources (K23-RR021973, UL1RR024134)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- obstructive sleep apnea, pediatric sleep apnea, insulin resistance, adiponectin, catecholamines, norepinephrine, HOMA, metabolic syndrome, puberty, obesity, apnea-hypopnea index, oxygen desaturation
- MeSH terms
- Adolescent, Age Factors, Blood Glucose, Catecholamines, Child, Child, Preschool, Female, Humans, Insulin Resistance, Male, Obesity, Cohort Studies, Body Mass Index, Case-Control Studies, Polysomnography, Sleep Apnea, Obstructive, Adiponectin
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