Background

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.

Methods

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.

Results

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.

Conclusions

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.

中文翻译：

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肥胖青少年进行减肥手术的阻塞性睡眠呼吸暂停：与代谢和心血管变量有关。

背景

阻塞性睡眠呼吸暂停综合症（OSA）是成人中已被广泛描述的疾病，严重肥胖者中患病率较高，而与此同时，与BMI无关的几种合并症也存在。有关严重肥胖青少年OSA的文献在质量和数量上受到限制，可能导致诊断和治疗欠佳。

方法

前瞻性收集了接受手术治疗的56例保守治疗难治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，卡方检验或Fisher精确检验评估无/轻度（呼吸暂停-呼吸不足指数（AHI）0-4.9）和中度/重度OSA（AHI≥5.0）的青少年之间的差异。进行多变量线性回归分析以评估若干变量与AHI的关联，并针对BMI z得分进行了校正。

结果

在53名受试者中，有48名（90.6％）表现出某种程度的睡眠呼吸障碍，其中20名（37.7％）患有中度/重度OSA。患有中度/重度OSA的患者平均颈围较高（42.4对40.1厘米，p  = 0.008），BMI z评分较高（3.7对3.4，p  = 0.003），血浆甘油三酸酯水平较高（2.2对1.5 mmol / L） ，p  = 0.012），并且 与没有/轻度OSA的那些相比，IGF较低（29.6对40.2 mmol / L，p = 0.010）。BMI z评分和血浆甘油三酸酯水平与AHI独立相关。

结论

OSA在病态肥胖的青少年中非常普遍，并且与BMI z评分密切相关。血浆甘油三酸酯水平升高与AHI相关，独立于BMI z评分。