青少年過重和肥胖與阻塞性睡眠呼吸中止症風險增加有關


  【24drs.com】December 21, 2009 — 根據發表於12月臨床睡眠醫學期刊(Journal of Clinical Sleep Medicine)的研究報告,和成人一樣,過重與肥胖青少年的阻塞性睡眠呼吸中止症(obstructive sleep apnea syndrome,OSAS)風險增加。
  
  澳洲阿德雷德大學的Mark J. Kohler博士等人寫道,過重和肥胖被視為會增加孩童的OSAS風險,不過,之前的結果並不一致,可能是因為研究之孩童的年紀與種族不同;為了確認過重和OSAS在各年齡層孩童的關聯,我們評估一系列轉診接受打鼾臨床評估的高加索孩童與青少年的多頻道睡眠記錄資料。
  
  研究者對疑似OSAS、轉診進行隔夜評估的234名2-18歲孩童,進行多頻道睡眠紀錄,確認OSAS嚴重度與身體質量指數(BMI)和年紀的函數。
  
  BMI z-分數每增加一個標準差(SD),青少年(年紀≧12歲)的OSAS風險增加3.5倍,不過,幼童中,OSAS風險與BMI增加沒有顯著關聯。
  
  研究者寫道,和成人類似,青少年過重與肥胖和OSAS風險增加有關,就高加索孩童來說,過重與肥胖應被視為12歲以上青少年的OSAS重要風險因素,特別是同時考量其他已經確定的風險因素、如打鼾和扁桃體腺樣體肥大時。
  
  研究限制包括缺乏一般性,因為研究對象只有疑似上呼吸道阻塞而轉診的高加索幼童和青少年,取樣方面可能有偏差。
  
  研究作者寫道,顯然地,OSAS的病因有多種因素,包括生理和解剖因素的交互影響,繼續確認這些因素,將是瞭解與OSAS有關病因之研究的重要關鍵,不過,研究者與醫師都應瞭解,這些因素在孩童時期隨著年紀而改變。
  
  本研究無產業支持,研究作者皆宣告沒有相關財務關係。

Overweight, Obesity in Teens Linked to Increased Risk for Obstructive Sleep Apnea Syndrome

By Laurie Barclay, MD
Medscape Medical News

December 21, 2009 — Similar to adults, adolescents have an increased risk of having obstructive sleep apnea syndrome (OSAS) in association with overweight and obesity, according to the results of a study reported in the December issue of the Journal of Clinical Sleep Medicine.

"Overweight and obesity are thought to increase the risk of...OSAS among children," write Mark J. Kohler, PhD, from University of Adelaide in Adelaide, Australia, and colleagues. "However, previous results have been inconsistent and appear to be confounded by both ethnicity and the different ages of children studied. To determine whether the association between excess weight and OSAS varies with age across childhood, we assessed polysomnographic data from a series of Caucasian children and adolescents referred for clinical evaluation of snoring."

The investigators performed polysomnography in 234 children aged 2.0 to 18.0 years who were referred for overnight evaluation of suspected OSAS, and they determined severity of OSAS as a function of body mass index (BMI) and age.

For each SD increase in BMI z-score, the risk for OSAS among adolescents (age ? 12 years) was increased 3.5-fold. Among younger children, however, the risk for OSAS was not significantly increased with increasing BMI.

"Similar to adults, adolescent children show an increased risk for having OSAS in association with overweight and obesity," the study authors write. "For Caucasian children, overweight and obesity should be considered a significant risk for OSAS among adolescents or from age 12 years, especially when in combination with other established risk factors, including snoring and adenotonsillar hypertrophy."

Limitations of this study include lack of generalizability because of Caucasian population referred for suspected upper airway obstruction and possible selection bias in referral of younger children vs adolescents.

"Clearly the etiology of OSAS is multifactorial, comprising an interaction of physiologic and anatomic factors," the study authors write. "The identification of these factors will continue to be an active and important field of research given the striking morbidity associated with OSAS. However, researchers and clinicians alike should realize that such factors appear to change with age during childhood."

This was not an industry-supported study, and the study authors have disclosed no relevant financial relationships.

J Clin Sleep Med. 2009;5:506-511.

    
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