Comparison of Frequency and Severity of Sleep-Related Breathing Disorders in Children with Simple Obesity and Paediatric Patients with Prader-Willi Syndrome.

Agnieszka Lecka-Ambroziak,Marta Wysocka-Mincewicz,Anna Świercz,Mieczysław Szalecki,Małgorzata Jędrzejczak

doi:10.3390/jpm11020141

Agnieszka Lecka-Ambroziak, Marta Wysocka-Mincewicz + Show 3 more

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https://doi.org/10.3390/jpm11020141

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Abstract

Sleep-related breathing disorders (SRBDs) can be present in children with simple obesity and with Prader–Willi syndrome (PWS) and influence an individual diagnostic and treatment approach. We compared frequency and severity of SRBDs in children with simple obesity and with PWS, both without and on recombinant human growth hormone (rhGH) treatment, and correlation of SRBDs with insulin resistance tests. A screening polysomnography-polygraphy (PSG), the oral glucose tolerance test (OGTT) and homeostasis model assessment of insulin resistance (HOMA-IR) were analysed in three groups of patients—with simple obesity (group 1, n = 30, mean age 14.2 years), patients with PWS without the rhGH therapy (group 2, n = 8, mean age 13.0 years) and during the rhGH treatment (group 3, n = 17, mean age 8.9 years). The oxygen desaturation index (ODI) was significantly higher in groups 2 and 3, compared to group 1 (p = 0.00), and hypopnea index (HI) was higher in group 1 (p = 0.03). Apnea–hypopnea index (AHI) and apnea index (AI) results positively correlated with the insulin resistance parameters in groups 1 and 3. The PSG values worsened along with the increasing insulin resistance in children with simple obesity and patients with PWS treated with rhGH that may lead to a change in the patients’ care.

Highlights

One girl was treated with metformin after impaired glucose tolerance and insulin resistance were diagnosed in the oral glucose tolerance test (OGTT)
In group 3, we found the correlation between Apnea–hypopnea index (AHI) with apnea index (AI) and both glucose (r = 0.53, p = 0.03; r = 0.50, p = 0.04) and insulin values (r = 0.58, p = 0.02; r = 0.57, p = 0.02) at 120 min of the OGTT and between the mean desaturation, with the mean desaturation time and homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.65, p = 0.01; r = 0.54, p = 0.03)
Our study proves the high incidence of SRBDs in obese children, both with simple obesity and in the group of patients with Prader–Willi syndrome (PWS) without recombinant human growth hormone (rhGH) treatment

Summary

Introduction

Sleep-related breathing disorders (SRBDs) have become a more recognized serious complication of obesity in paediatric population [1,2,3,4]. They can significantly worsen the proper psychomotor development in children as well as their physical and psychological health and quality of life [5]. Prader–Willi syndrome (PWS) is the common known genetic reason for obesity. It is a first recognized human genetic imprinting disorder, with the prevalence of 1 in 15,000 to 1 in 30,000, caused by lack of paternally-inherited genes on chromosome 15q11–q13. PWS results from either paternal deletion (DEL 15, 70%), maternal uniparental disomy (UPD 15, 15–30%) or imprinting centre defect (ID, 1%) [6]

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