ESPE Abstracts

Purpose: The main purpose of the study is to assess the association between obstructive sleep apnea (OSA) and insulin secretion in children with obesity.

Objectives: To achieve our aim we have assessed OSA and measured insulin secretion by the using the oral minimal model (OMM) in a cohort of 77 obese children and adolescents.

Methods: We retrospectively enrolled children and adolescents who have attended our pediatric outpatient obesity clinic because of obesity and suspected OSA. Glucose homeostasis, insulin-sensitivity, and insulin secretion were assessed through standard 2-hour OGTT. Nocturnal cardio-respiratory polygraphy was performed for OSA diagnosis. A subgroup of 22 patients underwent a 3-hour OGTT test to investigate insulin secretion and sensitivity though the oral-minimal model.

Results: Seventy-seven children and adolescents (11.3±2.9years, z-score BMI 3.53±0.76) were included in the study. All of them presented with OSA (29 had mild, 29 moderate, and 19 severe OSA). Based on OSA severity, the cohort was divided into three groups. The group with mild OSA showed lower 30-minutes glucose (P=0.01), 60-minutes glucose (P=0.03), and prevalence of elevated 1-hour glucose (10.4% vs 44.8% in moderate and 31.6% in severe OSA, P=0.01). The odds of showing elevated 1-hour plasma glucose was 6.2 fold (95% CI 1.6-23.4) higher in children with moderate and severe OSA compared to mild OSA (P=0.007) independent of confounders. Spearman correlation analyses revealed a positive correlation between 30-minutes plasma glucose and AHI (r=0.31, P=0.01), ODI (r=0.31, P=0.009), and mean desaturation (r=0.25, P=0.04). The exploratory study included 22 children and adolescents, 7 presented mild and 6 had severe OSA. The group with mild OSA showed a higher dynamic, static, and total insulin secretion compared to those with moderate and severe OSA (P<0.0001, P=0.007, P=0.007, respectively). OSA severity index (AHI) was significantly correlated to dynamic insulin secretion (r=-0.48, P=0.02).

Main Conclusion: OSA might impair beta-cell function reducing insulin secretion in obese children and adolescents, in the absence of an effect on insulin sensitivity.