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韩国儿童和青少年阻塞性睡眠呼吸暂停与血脂异常的关联:一项单中心横断面研究。

The association of obstructive sleep apnea with dyslipidemia in Korean children and adolescents: a single-center, cross-sectional study.

作者信息

Kang Eun Kyeong, Jang Min Jeong, Kim Ki Duk, Ahn Young Min

机构信息

Department of Pediatrics, Dongguk University Ilsan Hospital, Ilsan, Korea.

Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.

出版信息

J Clin Sleep Med. 2021 Aug 1;17(8):1599-1605. doi: 10.5664/jcsm.9258.

Abstract

STUDY OBJECTIVES

To evaluate whether obstructive sleep apnea (OSA) and its severity are related to dyslipidemia and alanine transaminase elevation as a marker of nonalcoholic fatty liver disease in children.

METHODS

The data collected from polysomnography, laboratory measurements (lipid profile and liver enzyme), and body mass index in children aged 0-18 years who visited the pediatric department between 2012 and 2018 were retrospectively analyzed.

RESULTS

There were a total of 273 participants in the study (ages 0-6 years, 7-12 years, and 13-18 years: 61.9%, 26.4%, and 11.7%, respectively). In the ages 7-12 and 13-18 years groups, obesity was strongly associated with OSA severity (Cramer's V = 0.498, < .001). High-density lipoprotein cholesterol levels were significantly lower in the OSA group than in the non-OSA group, irrespective of the presence of obesity. In addition, high-density lipoprotein cholesterol levels were significantly different between the OSA severity groups after adjusting for body mass index ( = .000). In participants who were obese, moderate and severe OSA were associated with alanine transaminase elevation ( = .023 and = .045, respectively).

CONCLUSIONS

This study suggests that OSA may be an independent risk factor for dyslipidemia and that OSA and obesity have a synergistic effect on alanine transaminase elevation. Early diagnosis and treatment of OSA from childhood, especially in obese children, will reduce metabolic complications.

CITATION

Kang EK, Jang MJ, Kim KD, Ahn YM. The association of obstructive sleep apnea with dyslipidemia in Korean children and adolescents: a single-center, cross-sectional study. 2021;17(8):1599-1605.

摘要

研究目的

评估儿童阻塞性睡眠呼吸暂停(OSA)及其严重程度是否与血脂异常以及作为非酒精性脂肪性肝病标志物的丙氨酸转氨酶升高有关。

方法

对2012年至2018年期间到儿科就诊的0至18岁儿童的多导睡眠图、实验室测量数据(血脂谱和肝酶)以及体重指数进行回顾性分析。

结果

该研究共有273名参与者(0至6岁、7至12岁和13至18岁的参与者分别占61.9%、26.4%和11.7%)。在7至12岁和13至18岁年龄组中,肥胖与OSA严重程度密切相关(克莱姆相关系数V = 0.498,P <.001)。无论是否存在肥胖,OSA组的高密度脂蛋白胆固醇水平均显著低于非OSA组。此外,在调整体重指数后,OSA严重程度组之间的高密度脂蛋白胆固醇水平存在显著差异(P =.000)。在肥胖参与者中,中度和重度OSA与丙氨酸转氨酶升高相关(分别为P =.023和P =.045)。

结论

本研究表明,OSA可能是血脂异常的独立危险因素,并且OSA与肥胖对丙氨酸转氨酶升高具有协同作用。从儿童期开始对OSA进行早期诊断和治疗,尤其是肥胖儿童,将减少代谢并发症。

引用文献

Kang EK, Jang MJ, Kim KD, Ahn YM. 韩国儿童和青少年阻塞性睡眠呼吸暂停与血脂异常的关联:一项单中心横断面研究。《儿科研究》2021;17(8):1599 - 1605。

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