de Sousa Caixêta Juliana Alves, Saramago Alex Martins, de Cácia Pradella-Hallinan Marcia Lourdes, Moreira Gustavo Antônio, Tufik Sergio, Fujita Reginaldo Raimundo
Department of Otorhinolaryngology, Federal University of São Paulo, Rua Padre Luis dos Anjos, 256, Bairro Jundiaí, Anápolis, Goias, Brazil, CEP: 75110-520,
Sleep Breath. 2015 Mar;19(1):231-7. doi: 10.1007/s11325-014-1001-1. Epub 2014 May 9.
Sleep-disordered breathing is caused by the interaction of multiple factors, including tonsillar hypertrophy, retrognathia, maxillary atresia, neuromuscular abnormalities, activation of inflammatory mediator cascades, and obesity. The prevalence and severity of obesity among children and adolescents increased worldwide during recent decades and has thus become a public health concern. The aim of this study is to assess the metabolic and anthropometric changes associated with sleep-disordered breathing in obese children.
Prospective assessment of prepubertal obese children followed at a pediatric endocrinology outpatient clinic that had history of frequent snoring. Children were submitted to polysomnography, measurements of body weight, height, blood pressure, neck circumference, and waist circumference. BMI, neck-to-height, and waist-to-height ratios were calculated. Laboratory tests included a complete blood count, liver function tests, lipid profile, and glucose metabolism assessment. Additionally, the presence of metabolic syndrome was assessed. Differences between obstructive sleep apnea and primary snoring groups were calculated using unpaired t-test, Fisher's exact test or Mann-Whitney test (p < 0.05).
The sample included 20 children with primary snoring and nine with obstructive sleep apnea. The two groups did not differ with regard to age, gender, BMI, or BMI z-score, serum lipids, glucose metabolism, cell count, liver function, or arterial blood pressure. Anthropometric data did not differ between groups. The waist-to-height ratio was greater among children with obstructive sleep apnea, compared to those with primary snoring.
In the present study, the waist-to-height ratio was greater in children with obstructive sleep apnea and, thus, could distinguish these children from those with primary snoring.
睡眠呼吸障碍是由多种因素相互作用引起的，包括扁桃体肥大、下颌后缩、上颌闭锁、神经肌肉异常、炎症介质级联反应激活和肥胖。近几十年来，全球儿童和青少年肥胖的患病率和严重程度都有所增加，因此已成为一个公共卫生问题。本研究的目的是评估肥胖儿童睡眠呼吸障碍相关的代谢和人体测量学变化。
对一家儿科内分泌门诊随访的青春期前肥胖儿童进行前瞻性评估，这些儿童有频繁打鼾史。对儿童进行多导睡眠图检查、体重、身高、血压、颈围和腰围测量。计算体重指数（BMI）、颈高比和腰高比。实验室检查包括全血细胞计数、肝功能检查、血脂谱和葡萄糖代谢评估。此外，评估代谢综合征的存在情况。使用非配对t检验、Fisher精确检验或Mann-Whitney检验计算阻塞性睡眠呼吸暂停组和原发性打鼾组之间的差异（p<0.05）。
样本包括20名原发性打鼾儿童和9名阻塞性睡眠呼吸暂停儿童。两组在年龄、性别、BMI或BMI z评分、血脂、葡萄糖代谢、细胞计数、肝功能或动脉血压方面无差异。两组间人体测量数据无差异。与原发性打鼾儿童相比，阻塞性睡眠呼吸暂停儿童的腰高比更大。
在本研究中，阻塞性睡眠呼吸暂停儿童的腰高比更大，因此可以将这些儿童与原发性打鼾儿童区分开来。
