Association of sleep characteristics with adiposity markers in children

Theresa Herttrich 1 , 2 , Johann Daxer 2 , 3 , Andreas Hiemisch 2 , 4 , Jens Kluge 2 , Andreas Merkenschlager 2 , Jürgen Kratzsch 5 , 8 , Kathrin Scheuermann 2 , Oskar G. Jenni 6 , Antje Körner 2 , 4 , 5 , Wieland Kiess 2 , 4 , 5 ,  and Mirja Quante 5 , 7
  • 1 Department of Palliative Medicine, Munich University Hospital, Munich, Germany
  • 2 Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
  • 3 Department of Neurology, Hospital Stuttgart, Stuttgart, Germany
  • 4 LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
  • 5 IFB Adiposity Diseases, Leipzig University, Leipzig, Germany
  • 6 Child Development Center, University Children’s Hospital Zurich, Zurich, Switzerland
  • 7 Department of Neonatology, University of Tuebingen, Tuebingen, Germany
  • 8 Institute of Laboratory Medicine, Leipzig University, Leipzig, Germany
Theresa Herttrich
  • Department of Palliative Medicine, Munich University Hospital, Munich, Germany
  • Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
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, Johann Daxer
  • Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
  • Department of Neurology, Hospital Stuttgart, Stuttgart, Germany
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, Andreas Hiemisch
  • Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
  • LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
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, Jens Kluge
  • Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
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, Andreas Merkenschlager
  • Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
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, Jürgen Kratzsch
  • IFB Adiposity Diseases, Leipzig University, Leipzig, Germany
  • Institute of Laboratory Medicine, Leipzig University, Leipzig, Germany
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, Kathrin Scheuermann
  • Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
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, Oskar G. Jenni, Antje Körner
  • Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
  • LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
  • IFB Adiposity Diseases, Leipzig University, Leipzig, Germany
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, Wieland Kiess
  • Hospital for Children and Adolescents, Department of Women and Child Health and Center for Pediatric Research, Leipzig University, Leipzig, Germany
  • LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
  • IFB Adiposity Diseases, Leipzig University, Leipzig, Germany
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and Mirja Quante
  • Corresponding author
  • IFB Adiposity Diseases, Leipzig University, Leipzig, Germany
  • Department of Neonatology, University of Tuebingen, Tuebingen, Germany
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Abstract

Background

Accumulating evidence suggests a relationship between sleep alterations and overweight/obesity in children. Our aim was to investigate the association of sleep measures other than obstructive sleep apnea or sleep duration with overweight/obesity and metabolic function in children.

Methods

We conducted a prospective cohort study in school- aged children (aged 5 to 8 years, prepubertal, and 12 to 15 years, pubertal) with overweight/obesity and normal-weight children. All children underwent a standardized in-laboratory polysomnography followed by a fasting blood assessment for glucose and metabolic testing. Subjective sleep measures were investigated by a 7-day sleep diary and questionnaire. We analyzed prepubertal and pubertal groups separately using logistic regression and partial correlation analyses.

Results

A total of 151 participants were analyzed. Overweight/obese children had significantly higher odds for arousal index (prepubertal children: 1.28, Confidence interval (CI): 1.06, 1.67; pubertal children: 1.65, CI: 1.19, 2.29) than normal-weight children, independent of age and gender. In prepubertal children, arousal-index was positively associated with C-peptide (r=0.30, p=0.01), whereas Minimum O2 saturation was negatively associated with triglycerides (r=−0.34, p=0.005), adjusting for age and sex. However, associations were attenuated by further adjustment for body mass index standard deviation scores (BMI-SDS). In pubertal children, higher level of apnea-hypopnea-index and pCO2 predicted increased lipoprotein (a) levels (r=0.35, p=0.03 and r=0.40, p=0.01, respectively), independent of age, sex, and BMI-SDS. A negative association was found between pCO2 and high-density lipoprotein (HDL)-cholesterol (r=−0.40, p=0.01).

Conclusions

Overall, we report that sleep quality as measured by arousal index may be compromised by overweight and obesity in children and warrants attention in future intervention programs.

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The Journal of Pediatric Endocrinology and Metabolism (JPEM) is the only international journal dedicated exclusively to endocrinology in the neonatal, pediatric and adolescent age groups, and publishes the results of clinical investigations in pediatric endocrinology and basic research. JPEM publishes Review Articles, Original Research, Case Reports, Short Communications and Letters to the Editor.

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