Pacheco Susana Rebelo, Miranda Ana Margalha, Coelho Raquel, Monteiro Ana Cristina, Bragança Graciete, Loureiro Helena Cristina
Pediatric Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal.
Arch Endocrinol Metab. 2017 Jul-Aug;61(4):367-373. doi: 10.1590/2359-3997000000265. Epub 2017 Jun 26.
Overweight seems to be related to a higher prevalence of sleep disturbances. Decreased sleep duration and altered sleep quality are risk factors for obesity. Our aim was to compare the sleep pattern of overweight children with that of a matched control group and assess the relationship between sleep quality and obesity.
Retrospective cohort study comparing 41 overweight children with a normal-weight control group, both submitted to polysomnography. The samples were matched for age, sex, and apnea-hypopnea index. Body mass index (BMI) z-scores were calculated using World Health Organization (WHO) growth charts. Insulin resistance in the study group was determined using the homeostatic model assessment for insulin resistance (HOMA-IR). Sleep patterns were compared. The statistical analysis was performed using SPSS® version 21.
The mean age (± standard deviation) of the population was 10 ± 3.4 years (min. 5 years; max. 17 years). Fifty-six percent of the participants in both groups were girls. N3% was lower in the study group (18.95 ± 6.18%) compared with the control group (21.61 ± 7.39%; t (40) = 2.156, p = 0.037). We found a correlation in the study group between HOMA-IR and N3% (Rs = -0.434, p = 0.008).
The present study suggests a link between overweight/obesity and altered sleep quality due to compromised non-rapid eye movement sleep, an indirect marker of sleep quality. There was also a link between slow-wave sleep duration and insulin resistance. We must find a strategy to provide adequate slow-wave sleep duration to reduce the obesity epidemic at young ages. Further research is needed.
超重似乎与睡眠障碍的较高患病率相关。睡眠时间减少和睡眠质量改变是肥胖的危险因素。我们的目的是比较超重儿童与匹配对照组的睡眠模式，并评估睡眠质量与肥胖之间的关系。
回顾性队列研究，比较41名超重儿童与正常体重对照组，两组均接受多导睡眠图检查。样本在年龄、性别和呼吸暂停低通气指数方面进行匹配。使用世界卫生组织（WHO）生长图表计算体重指数（BMI）z评分。研究组的胰岛素抵抗采用胰岛素抵抗稳态模型评估（HOMA-IR）来确定。比较睡眠模式。使用SPSS®21版进行统计分析。
研究人群的平均年龄（±标准差）为10±3.4岁（最小5岁；最大17岁）。两组中56%的参与者为女孩。研究组的N3%（18.95±6.18%）低于对照组（21.61±7.39%；t（40）=2.156，p=0.037）。我们发现研究组中HOMA-IR与N3%之间存在相关性（Rs=-0.434，p=0.008）。
本研究表明超重/肥胖与因非快速眼动睡眠受损导致的睡眠质量改变之间存在联系，非快速眼动睡眠是睡眠质量的一个间接指标。慢波睡眠时间与胰岛素抵抗之间也存在联系。我们必须找到一种策略来提供足够的慢波睡眠时间，以减少年轻时的肥胖流行。还需要进一步的研究。
