scholarly journals MODERN VIEWS ON METABOLIC SYNDROME IN CHILDREN AND ADOLESCENTS

2019 ◽  
pp. 27-39
Author(s):  
O. O. Tolstikova ◽  
S. F. Aharkov
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Children And Adolescents ◽  
Fold Increase ◽  
Obstructive Sleep

Metabolic syndrome (MS) is a growing serious health risk in adults, children and adolescents. The prevalence of metabolic syndrome ranges from 6 to 39 % depending on the criteria used. Multiple data have shown that MS is associated with a 2-fold increase in cardiovascular disorders and a 1.5-fold increase in all cause mortality. To date, there is no single definition regarding MS for children and adolescents. However, most authors agree with the components needed to diagnose such as central obesity, impaired glucose tolerance (or diabetes), hypertension, and dyslipidemia; each of which presents a serious risk of cardiovascular disease. Overweight and obesity are often seen in children and adolescents in the developed and developing countries with a prevalence of 20–35 %. A number of authors have emphasized the need for a modern adapted definition of MS in children and adolescents. For this purpose, it is necessary to take into account age and sex-dependent anthropometric, metabolic and cardiovascular parameters. Recently, a link has been established between metabolic syndrome and non-alcoholic fatty liver disease, as well as hyperuricemia and sleep disorders. According to current data, NAFLD and MS are closely related, so NAFLD is described as a manifestation of MS in the liver, with insulin resistance being the driving force of pathogenesis. A recent study found that 66 % of children with NAFLD confirmed by biopsy had MS, 63 % had hypertriglyceridemia, 45 % had low HDL cholesterol, 40 % had hypertension, and 10 % had impaired glucose tolerance. The correlation between levels of serum uric acid, MS and some of its components in children and adolescents is described. Hyperuricemia triggers endothelial dysfunction via vasodilation caused by insulin action. Obstructive sleep apnea is associated with MS in children and adolescents and is described as one of the components of MS. In 59 % of children with obstructive sleep apnea, signs of metabolic syndrome are noted. Biomarkers, such as adipocytokines, have been the subject of current research as they are implicated in the pathogenesis of MS. Recently, several adipocytokines and inflammatory cytokines have been identified that have significant positive (leptin, hemerin, vaspine, TNFα, IL-6, and IL-8) or Negative (adiponectin) associations with metabolic risk factors. Some may be considered pathophysiological factors that link obesity and its complications, such as insulin resistance and NAFLD. Epigenetics and gestational programming are important issues in addressing MS in children and adolescents. The role of micro-RNA in the diagnosis, stratification and therapy of MS is increasing. Early identification of risk factors, screening for metabolic disorders and the identification of new treatments are the primary goals of reducing morbidity and mortality. Currently, officially accepted approaches to treating children and adolescents with MS are dietary changes and physical activity. Pharmacological therapy and the use of bariatric (metabolic) surgery is a topic of discussion and is recommended for adolescents in some cases of high-risk MS.

The Association of Obstructive Sleep Apnea With Insulin Resistance and Metabolic Syndrome

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 615A
Author(s):  
Hwa Sik Moon ◽  
Hyeon Hui Kang ◽  
Sang Haak Lee ◽  
Jin Woo Kim ◽  
Chan Kwon Park ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep

Obstructive sleep apnea syndrome is associated with metabolic syndrome rather than insulin resistance

2006 ◽  
Vol 11 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Altan Onat ◽  
Gülay Hergenç ◽  
Hüseyin Uyarel ◽  
Mehmet Yazıcı ◽  
Mustafa Tuncer ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Prevalence and Risk Factors for Obstructive Sleep Apnea Syndrome Among Children and Adolescents with Cleft lip and Palate: A Survey Study in Hong Kong

2021 ◽  
pp. 105566562110683
Author(s):  
A. C. H. Ho ◽  
F. Savoldi ◽  
R. W. K. Wong ◽  
S. C. Fung ◽  
S. K. Y. Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Hong Kong ◽  
Sleep Apnea ◽  
Children And Adolescents ◽  
Cleft Lip ◽  
Sleep Apnea Syndrome ◽  
Survey Study ◽  
Obstructive Sleep ◽  
Secondary Palate

Objective To investigate the prevalence of obstructive sleep apnea syndrome (OSAS) risk and related risk factors among children and adolescents of Hong Kong with cleft lip and/or palate (CL/P). Design Retrospective survey study adopting three questionnaires, obstructive sleep apnea-18 (OSA-18), pediatric sleep questionnaire-22 (PSQ-22), and modified Epworth Sleepiness Scale (ESS). Settings Multicenter study in two public hospitals. Patients A total of 351 Chinese children and adolescents with non-syndromic CL/P (6-18-year-old, 57% males) visited between September 2017 and November 2019, with primary palatal repair surgery done before 3-year-old. Main Outcome Measure Positive OSAS risk was determined based on cut-off ≥60 for OSA-18, ≥8 for PSQ-22, and >8 for ESS. Age, sex, overweight presence, cleft type, embryonic secondary palate involvement, palatal repair surgery, palatal revision surgery, and orthodontic treatment were analyzed as possible risk factors. Results A total of 9.5% of patients had positive OSAS risk based on OSA-18, 13.6% based on PSQ-22, and 13.2% according to ESS. A higher prevalence of patients with positive OSAS risk was of younger age (OSA-18, p = .034), had cleft involving embryonic secondary palate (PSQ-22, p = .009), and history of fixed orthodontic treatment (ESS, p = .002). The regression model identified only involvement of embryonic secondary palate as a risk factor (PSQ-22, odds ratio = 3.7, p = .015). Conclusions OSAS risk among children and adolescents of Hong Kong with CL/P was 9.5% to 13.6%. Patients at higher risk were those with cleft involving embryonic secondary palate. OSAS risk assessment may be influenced by different aspects of the disease spectrum, and a multimodal approach should be considered for such assessment.

scholarly journals Lack of Association Between Impaired Glucose Tolerance and Appetite Regulating Hormones in Patients with Obstructive Sleep Apnea

2011 ◽  
Vol 07 (05) ◽  
pp. 486-492 ◽  
Author(s):  
Ioannis Papaioannou ◽  
Michael Patterson ◽  
Gillian L. Twigg ◽  
Ali Vazir ◽  
Mohammad Ghatei ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Obstructive Sleep

scholarly journals Gender Differences in the Context of Obstructive Sleep Apnea and Metabolic Diseases

2021 ◽  
Vol 12 ◽  
Author(s):  
Fátima O. Martins ◽  
Sílvia V. Conde
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Gender Differences ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Metabolic Diseases ◽  
Hormone Replacement ◽  
Reproductive Age ◽  
Endocrine Disorders ◽  
Obstructive Sleep

The relationship between obstructive sleep apnea (OSA) and endocrine and metabolic disease is unequivocal. OSA, which is characterized by intermittent hypoxia and sleep fragmentation, leads to and exacerbates obesity, metabolic syndrome, and type 2 diabetes (T2D) as well as endocrine disturbances, such as hypothyroidism and Cushing syndrome, among others. However, this relationship is bidirectional with endocrine and metabolic diseases being considered major risk factors for the development of OSA. For example, polycystic ovary syndrome (PCOS), one of the most common endocrine disorders in women of reproductive age, is significantly associated with OSA in adult patients. Several factors have been postulated to contribute to or be critical in the genesis of dysmetabolic states in OSA including the increase in sympathetic activation, the deregulation of the hypothalamus-pituitary axis, the generation of reactive oxygen species (ROS), insulin resistance, alteration in adipokines levels, and inflammation of the adipose tissue. However, probably the alterations in the hypothalamus-pituitary axis and the altered secretion of hormones from the peripheral endocrine glands could play a major role in the gender differences in the link between OSA-dysmetabolism. In fact, normal sleep is also different between men and women due to the physiologic differences between genders, with sex hormones such as progesterone, androgens, and estrogens, being also connected with breathing pathologies. Moreover, it is very well known that OSA is more prevalent among men than women, however the prevalence in women increases after menopause. At the same time, the step-rise in obesity and its comorbidities goes along with mounting evidence of clinically important sex and gender differences. Metabolic and cardiovascular diseases, seen as a men's illness for decades, presently are more common in women than in men and obesity has a higher association with insulin-resistance-related risk factors in women than in men. In this way, in the present manuscript, we will review the major findings on the overall mechanisms that connect OSA and dysmetabolism giving special attention to the specific regulation of this relationship in each gender. We will also detail the gender-specific effects of hormone replacement therapies on metabolic control and sleep apnea.

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