Sleep-disordered breathing in adolescents with obesity: When does it start to affect cardiometabolic health?

Abstract Objectives Pediatric obesity and sleep-disordered breathing (SDB) are associated with cardiometabolic risk (CMR), but the degree of severity at which SDB affects cardiometabolic health is unknown. We assessed the relationship between the CMR and the apnea-hypopnea index (AHI), tending to identify a threshold of AHI from which an increase in the CMR is observed, in adolescents with obesity. We also compared the clinical, cardiometabolic and sleep characteristics between adolescents presenting a high (CMR+) and low CRM (CMR-), according to the threshold of AHI. Methods 114 adolescents with obesity were recruited from three institutions specialized in obesity management. Sleep and SDB as assessed by polysomnography, anthropometric parameters, fat mass (FM), glucose and lipid profiles, and blood pressure (BP) were measured at admission. Continuous (MetScoreFM) and dichotomous (metabolic syndrome, MetS) CMR were determined. Associations between MetScoreFM and AHI adjusted for sex and age were assessed by multivariable analyses. Results Data of 82 adolescents were analyzed. Multivariable analyses enabled us to identify a threshold of AHI≥2 above which we observed a strong and significant association between CMR and AHI (Cohen’s d effect-size=0.57 [0.11;1.02] p=0.02). Adolescents with CMR+ exhibited higher MetScoreFM (p Conclusions The identification of a threshold of AHI≥2 corresponding to the cardiometabolic alterations highlights the need for the early management of SDB and obesity in adolescents, to prevent cardiometabolic diseases. Clinical trials NCT03466359, NCT02588469 and NCT01358773.