Andersen Ida Gillberg, Holm Jens-Christian, Homøe Preben
Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Lykkebækvej 1, 4600, Køge, Denmark; The Children's Obesity Clinic, Department of Pediatrics, Holbæk University Hospital, Smedelundsgade 60, 4300, Holbæk, Denmark.
The Children's Obesity Clinic, Department of Pediatrics, Holbæk University Hospital, Smedelundsgade 60, 4300, Holbæk, Denmark; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Blegdamsvej 3A, 2200, Copenhagen, Denmark.
Int J Pediatr Otorhinolaryngol. 2019 Aug;123:57-62. doi: 10.1016/j.ijporl.2019.04.031. Epub 2019 Apr 24.
To evaluate the impact of weight-loss management on obstructive sleep apnea (OSA) in children and adolescents with obesity. We hypothesized that a reduction in the degree of obesity was associated with a reduction in the apnea-hypopnea index (AHI).
OSA (AHI ≥2) was investigated using a type 3 portable sleep device (Nox T3) in children and adolescents aged 7-18 years with overweight or obesity (body mass index standard deviation score (BMI SDS) > 1.28) at enrollment in a chronic care multidisciplinary overweight- and obesity treatment clinic. Individuals with OSA were included prospectively and longitudinally. A follow-up sleep examination was performed after 6 and 12 months from baseline accompanied by anthropometric measurements.
At baseline, 62 children with OSA were included (median age = 13.4 years, median BMI SDS = 3.16). A total of 55 out of 62 children (89%) attended the first follow-up, and 29 out of 34 children (85%) with residual OSA attended the second follow-up. By the end of the study, the AHI was normalized in 27 out of 62 children (44%). In a multiple linear regression analysis, the decrease in BMI SDS was associated with the decrease in AHI upon the first follow-up (p = 0.02) independently of sex; age; baseline puberty stage; baseline tonsillar hypertrophy; baseline AHI; baseline BMI SDS; and time to follow-up. There was no association between change in BMI SDS and change in AHI from the first to the second follow-up (p = 0.81).
OSA improved during obesity treatment, and the reduction in BMI SDS was significantly associated with the reduction in AHI after approximately six months of treatment. This indicates that obesity treatment should be considered among the first-line treatments of OSA in children and adolescents affected by overweight or obesity.
评估体重管理对肥胖儿童和青少年阻塞性睡眠呼吸暂停（OSA）的影响。我们假设肥胖程度的降低与呼吸暂停低通气指数（AHI）的降低相关。
在一家慢性护理多学科超重和肥胖治疗诊所，对7至18岁超重或肥胖（体重指数标准差评分（BMI SDS）>1.28）的儿童和青少年使用3型便携式睡眠设备（Nox T3）进行OSA（AHI≥2）调查。前瞻性和纵向纳入患有OSA的个体。在基线后的6个月和12个月进行随访睡眠检查，并进行人体测量。
基线时，纳入62名患有OSA的儿童（中位年龄=13.4岁，中位BMI SDS=3.16）。62名儿童中有55名（89%）参加了第一次随访，34名仍有OSA的儿童中有29名（85%）参加了第二次随访。到研究结束时，62名儿童中有27名（44%）的AHI恢复正常。在多元线性回归分析中，BMI SDS的降低与第一次随访时AHI的降低相关（p=0.02），且与性别、年龄、基线青春期阶段、基线扁桃体肥大、基线AHI、基线BMI SDS和随访时间无关。从第一次随访到第二次随访，BMI SDS的变化与AHI的变化之间无关联（p=0.81）。
肥胖治疗期间OSA有所改善，治疗约6个月后，BMI SDS的降低与AHI的降低显著相关。这表明，对于受超重或肥胖影响的儿童和青少年，肥胖治疗应被视为OSA的一线治疗方法之一。
