Can sleep disordered breathing result in metabolic abnormalities?

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It is well known that obesity, and in particular central obesity, in adults is related to the development of the metabolic syndrome, a constellation of factors, including insulin resistance, dyslipidemia, and hypertension, which is associated with increased risk of diabetes and cardiovascular disease. Recent studies have also implicated sleep disordered breathing as part of these interrelationships. There has not been extensive research in this area for pediatric patients. In this issue of The Journal, Verhulst et al assessed whether sleep disordered breathing is a risk factor for the metabolic syndrome in overweight children and adolescents. They found that indicators of sleep disordered breathing were independent predictors of the metabolic syndrome. They also showed that, after controlling for obesity, sleep variables were associated with low HDL-cholesterol, higher triglycerides, and elevated glucose levels during an oral glucose tolerance test. These results support the concept that these variables are interrelated in children as well as adults. It may be beneficial to diagnose and treat sleep disordered breathing in overweight children in an effort to prevent future cardiovascular disease.