Obstructive sleep related breathing disorders and cardiometabolic risk factors – A Portuguese birth cohort

• Published in: Respiratory medicine Vol. 222; p. 107531
• Main Authors: Costa, Mariana, Correia-Costa, Liane, Santos, Ana Cristina, Azevedo, Inês
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2024
• Subjects: Birth Cohort; Body Mass Index; Cardiometabolic Risk Factors; Child; Children; Cholesterol; Female; Humans; Hypertension; Insulin; Male; Obesity; Overweight - epidemiology; Pediatric Obesity - epidemiology; Portugal - epidemiology; Risk Factors; Sleep; Sleep disorders; Portugal; Hypertension; Sleep disorders; Obesity; Sleep; Children
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2024.107531

Pediatric obstructive sleep related breathing disorders (SRBD) are an important under-diagnosed health problem with associated cardiometabolic comorbidities, demonstrated with polysomnographic studies in selected samples. Our main goal was to assess the prevalence of SRBD in a population-based cohort and to analyze its association with cardiometabolic risk factors, in general and by sex. Pediatric Sleep Questionnaire (PSQ) was applied to parents of 7-years-old children evaluated in the birth cohort, Generation XXI. Sex, anthropometrics, blood pressure (BP), lipid profile, glucose, insulin, HOMA-IR, and high-sensitivity C-reactive protein were compared among children with/without SRBD, using Chi-square, Mann-Whitney tests and logistic regression models. A total of 1931 children (51.2 % boys) were included; 17.5 % were overweight and 15.7 % obese. The prevalence of SRBD was 13.4 %, more frequent among boys (15.7 % vs.10.9 %, p = 0.002) and in overweight/obese children (22.0 % vs.13.6 % vs.11.3 % in obese, overweight and normal weight group, respectively, p < 0.001). Children with SRBD had higher systolic BP (107 ± 8 vs.105±9 mmHg; p = 0.001) and lower HDL-cholesterol levels (54 ± 11 vs.56 ± 11 mg/dL; p = 0.04) than children without SRBD. After adjustment for sex, age, birthweight-for-gestational age and maternal age, children with SRBD had higher BMI-z-score, systolic BP, insulin and HOMA-IR levels, and lower HDL-cholesterol, when compared to those without SRBD, but these associations were lost when adjusting to BMI z-score. Analyzing obese children with the same regression model, those with SRBD presented lower HDL-cholesterol than those without SRBD. Our results identified a male predominance of SRBD in pre-pubertal children and highlighted the potential contribution of SRBD to cardiovascular risk in obese children. •The prevalence of pediatric SRBD was of 13.4 % in our population-based birth cohort.•A higher prevalence of SRBD was found in male children.•Female children presented higher levels of several cardiometabolic risk variables.•Obese children with SRBD presented lower HDL-cholesterol levels.