Talib Ali, Roebroek Yvonne G M, van Waardenburg Dick A, van der Grinten Chris P M, Winkens Bjorn, Bouvy Nicole D, van Heurn Ernst L W E
Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands; Department of General Surgery, Maxima Medical Center, Veldhoven, The Netherlands.
Sleep Med. 2020 Nov;75:246-250. doi: 10.1016/j.sleep.2020.02.026. Epub 2020 Mar 6.
obstructive sleep apnea syndrome (OSA) is a well-described disease entity in adults, with a higher prevalence in severely obese individuals, while at the same time associated with several comorbidities independently of BMI. Literature regarding OSA in severely obese adolescents is qualitatively and quantitatively limited, possibly resulting in suboptimal diagnosis and treatment.
polysomnographic, demographic, anthropometric, and comorbidity-related data were prospectively collected in 56 adolescents with morbid obesity refractory to conservative treatment who presented for surgical therapy. Differences between adolescents with no/mild (apnea-hypopnea index (AHI) 0-4.9) and moderate/severe OSA (AHI ≥ 5.0) were evaluated using independent-samples t, chi-square or Fisher's exact tests. Multivariable linear regression analysis was performed to evaluate the association of several variables with AHI, corrected for BMI z-score.
of the 53 included subjects, 48 (90.6%) showed some degree of sleep disordered breathing and 20 (37.7%) had moderate/severe OSA. Patients with moderate/severe OSA had on average a higher neck circumference (42.4 versus 40.1 cm, p = 0.008), higher BMI z-score (3.7 versus 3.4, p = 0.003), higher plasma triglyceride level (2.2 versus 1.5 mmol/L, p = 0.012), and lower IGF (29.6 versus 40.2 mmol/L, p = 0.010) than those with no/mild OSA. BMI z-score and plasma triglyceride levels were independently related to AHI.
OSA is highly prevalent amongst morbidly obese adolescents and is strongly associated with BMI z-score. Elevated plasma triglyceride levels are associated with AHI, independent of BMI z-score.
阻塞性睡眠呼吸暂停综合征（OSA）在成年人中是一种广为人知的疾病实体，在重度肥胖个体中患病率较高，同时与多种合并症相关，且独立于体重指数（BMI）。关于重度肥胖青少年OSA的文献在质量和数量上都有限，这可能导致诊断和治疗不够理想。
前瞻性收集了56名因保守治疗无效而前来接受手术治疗的病态肥胖青少年的多导睡眠图、人口统计学、人体测量学和合并症相关数据。使用独立样本t检验、卡方检验或Fisher精确检验评估无/轻度（呼吸暂停低通气指数（AHI）0 - 4.9）和中度/重度OSA（AHI≥5.0）青少年之间的差异。进行多变量线性回归分析以评估多个变量与AHI的关联，并对BMI z评分进行校正。
在纳入的53名受试者中，48名（90.6%）表现出一定程度的睡眠呼吸紊乱，20名（37.7%）患有中度/重度OSA。中度/重度OSA患者的平均颈围更高（42.4对40.1厘米，p = 0.008），BMI z评分更高（3.7对3.4，p = 0.003），血浆甘油三酯水平更高（2.2对1.5毫摩尔/升，p = 0.012），胰岛素样生长因子（IGF）更低（29.6对40.2毫摩尔/升，p = 0.010），均高于无/轻度OSA患者。BMI z评分和血浆甘油三酯水平与AHI独立相关。
OSA在病态肥胖青少年中非常普遍，且与BMI z评分密切相关。血浆甘油三酯水平升高与AHI相关，独立于BMI z评分。
