Bahgat Karima Abdelfattah, Elhady Marwa, Alkholy Tawfik Abd Elatey, Elgaber Fatma Mohamed Abd, Shipl Walaa, Gobarah Ayman A
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Arch Med Sci. 2019 Sep 19;17(5):1332-1339. doi: 10.5114/aoms.2019.86895. eCollection 2021.
Sleep disordered breathing (SDB) represents common comorbidities of childhood obesity leading to interrupted sleep and sleep deprivation. Sleep deprivation alters secretion of brain-derived neurotrophic factor (BDNF), which is an appetite regulator. However, little is known about the relation between BDNF and central obesity in children with SDB. The aim of the study was to evaluate BDNF level and anthropometric indices in relation to SDB in children with obesity.
A prospective case-control study was conducted on 30 children with obesity (BMI > 95 percentile) and 30 healthy lean children (BMI 5-85 percentile). Polysomnographic, anthropometric data and BDNF serum level were obtained from all included children. Serum level of BDNF and anthropometric indices of obesity were assessed in relation to SDB in children with obesity. Regression analysis was done to determine predictors for SDB in children with obesity.
In comparison to healthy controls, anthropometric indices of central obesity were significantly higher while BDNF was significantly lower in obese children, especially those with SDB. Respiratory disturbance index has a significant positive correlation with anthropometric indices of central obesity and a significant negative correlation with BDNF level. Central obesity and decreased BDNF were associated with 2-fold increased risk for SDB. Waist circumference/height ratio and neck circumference/height ratio have 89.5%, 75% sensitivity and 81.23%, 84.62% specificity at a cutoff point > 0.62, > 0.24 respectively for prediction of SDB in children with obesity.
Central obesity and decreased BDNF represent independent predictors for SDB in children with obesity. Anthropometric indices adjusted to height are a simple screening tool for SDB in obese children.
睡眠呼吸障碍（SDB）是儿童肥胖常见的合并症，会导致睡眠中断和睡眠剥夺。睡眠剥夺会改变脑源性神经营养因子（BDNF）的分泌，而BDNF是一种食欲调节因子。然而，关于BDNF与患有SDB的儿童中心性肥胖之间的关系，人们知之甚少。本研究的目的是评估肥胖儿童中与SDB相关的BDNF水平和人体测量指标。
对30名肥胖儿童（BMI>第95百分位数）和30名健康瘦儿童（BMI为第5 - 85百分位数）进行了一项前瞻性病例对照研究。从所有纳入的儿童中获取多导睡眠图、人体测量数据和BDNF血清水平。评估肥胖儿童中与SDB相关的BDNF血清水平和肥胖人体测量指标。进行回归分析以确定肥胖儿童中SDB的预测因素。
与健康对照组相比，肥胖儿童，尤其是患有SDB的儿童，中心性肥胖的人体测量指标显著更高，而BDNF显著更低。呼吸紊乱指数与中心性肥胖的人体测量指标呈显著正相关，与BDNF水平呈显著负相关。中心性肥胖和BDNF降低与SDB风险增加两倍相关。腰围/身高比和颈围/身高比在截断点分别>0.62、>0.24时，对肥胖儿童SDB的预测敏感性分别为89.5%、75%，特异性分别为81.23%、84.62%。
中心性肥胖和BDNF降低是肥胖儿童SDB的独立预测因素。根据身高调整的人体测量指标是肥胖儿童SDB的一种简单筛查工具。
