Obstructive sleep apnea (OSA) is associated with the impairment of beta-cell response to glucose in children and adolescents with obesity

Umano, GR; Galderisi, A; Aiello, F; Martino, M; Camponesco, O; Di Sessa, A; Marzuillo, P; Alfonso, P; Miraglia Del Giudice, E

doi:10.1038/s41366-023-01257-w

Obesity

Obstructive sleep apnea (OSA) is associated with the impairment of beta-cell response to glucose in children and adolescents with obesity

Int J Obes (Lond)Published 20 Jan 2023Cross-sectional study

Main finding · Elevated 1-h glucose (OGTT)ResultOdds ratio 6.2 95% CI 1.6–23.4

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Authors' conclusion

OSA might impair beta-cell function reducing the pool of promptly releasable insulin in children and adolescents with obesity, in the absence of an effect on insulin sensitivity.

Study context

Population: Children and adolescents with obesity and OSA attending a pediatric clinic
Participants: 77 children

Exposure: Mild vs moderate vs severe OSA
Mild OSAn = 29reference
Moderate OSAn = 29
Severe OSAn = 19
Outcome: Association between OSA and insulin secretion

Main finding

Elevated 1-h glucose (OGTT)

Odds ratio

6.2

95% CI 1.6–23.4

P = 0.007

By group

Mild OSA10.4%

Moderate OSA44.8%

Severe OSA31.6%

Moderate and severe OSAvs Mild OSA

OR 6.2 (95% CI 1.6–23.4); P = 0.007

As reported in the abstract

Observational data: associations, not effects.

Further findings

30-min and 60-min glucose (oral glucose tolerance test (OGTT))

Lower 30-min glucose with mild OSA: P = 0.01
Lower 60-min glucose with mild OSA: P = 0.03

Spearman correlations of 30-min glucose

With apnea-hypopnea index (AHI): r = 0.31, p = 0.01
With oxygen desaturation index (ODI): r = 0.31, p = 0.009
With mean desaturation: r = 0.25, p = 0.04

Insulin secretion (oral-minimal model, 3-h OGTT)

Higher dynamic insulin secretion with mild vs moderate and severe OSA: P < 0.0001
Higher static insulin secretion with mild vs moderate and severe OSA: P = 0.007
Higher total insulin secretion with mild vs moderate and severe OSA: P = 0.007
AHI correlated with dynamic insulin secretion: r = −0.48, p = 0.02

Subset n = 22 (7 mild, 9 moderate, 6 severe OSA)

Original publication

Obstructive sleep apnea (OSA) is associated with the impairment of beta-cell response to glucose in children and adolescents with obesity. Int J Obes (Lond). Published 20 January 2023. doi:10.1038/s41366-023-01257-w

Read the original article ↗

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