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Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis.
Metabolism. 2017 11; 76:70-80.M

Abstract

PURPOSE

Obstructive sleep apnea (OSA), typically manifested as snoring, is closely associated with obesity. However, the directionality of associations of OSA with cardiometabolic risk markers is unclear, as obesity increases risk for OSA, and OSA results in excess weight gain and its metabolic consequences. Less is known about how obesity and OSA may relate in children and adolescents and whether maternal OSA may influence the development of obesity and cardiometabolic dysfunction in offspring.

BASIC PROCEDURES

Among 1078 children from the Project Viva cohort, we examined cross-sectionally and prospectively associations of parent-reported child or maternal snoring with cardiometabolic outcomes, including adiposity, adipokines, and insulin resistance.

MAIN FINDINGS

Cross-sectionally, child snoring was related to adiposity and metabolic risk, particularly body mass index (BMI; β 0.61kg/m2, 95% CI 0.33, 0.89; p<0.001), trunk fat mass index (β 0.23kg/m2, CI 0.12, 0.34; p<0.001), high-density lipoprotein cholesterol (β -1.47mg/dL, CI -2.69, -0.25; p=0.02), and metabolic risk z-score (β 0.08, CI 0.02, 0.14; p=0.01) after correction for covariates. Prospectively, adiposity (BMI, trunk fat, fat mass, and waist circumference) and cardiometabolic (leptin, HOMA-IR, CRP, and global metabolic risk) measures at mid-childhood (~7y) were associated with child snoring at the early teen visit (~12y) after correction for covariates. Child snoring at ~9y was related to changes in adiposity between mid-childhood and early teen visits.

CONCLUSIONS

Child but not maternal snoring, was related to child adiposity and cardiometabolic outcomes. Adiposity and child snoring are associated with each other cross-sectionally and are each predictive of the other among children/adolescents prospectively. These results suggest similar mechanisms in pediatric/adolescent populations as in adults for the development of sleep-disordered breathing and sleep apnea that will need to be confirmed in randomized clinical trials. Importantly, this research points to the need to target both sleep and obesity in order to break this vicious cycle.

Authors+Show Affiliations

Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States. Electronic address: ofarr@bidmc.harvard.edu.Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States.Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard School of Public Health, Boston, MA, United States.Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States.Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States; Section of Endocrinology, VA Boston Healthcare System, Boston, MA, United States.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

28774733

Citation

Farr, Olivia M., et al. "Current Child, but Not Maternal, Snoring Is Bi-directionally Related to Adiposity and Cardiometabolic Risk Markers: a Cross-sectional and a Prospective Cohort Analysis." Metabolism: Clinical and Experimental, vol. 76, 2017, pp. 70-80.
Farr OM, Rifas-Shiman SL, Oken E, et al. Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis. Metabolism. 2017;76:70-80.
Farr, O. M., Rifas-Shiman, S. L., Oken, E., Taveras, E. M., & Mantzoros, C. S. (2017). Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis. Metabolism: Clinical and Experimental, 76, 70-80. https://doi.org/10.1016/j.metabol.2017.06.008
Farr OM, et al. Current Child, but Not Maternal, Snoring Is Bi-directionally Related to Adiposity and Cardiometabolic Risk Markers: a Cross-sectional and a Prospective Cohort Analysis. Metabolism. 2017;76:70-80. PubMed PMID: 28774733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current child, but not maternal, snoring is bi-directionally related to adiposity and cardiometabolic risk markers: A cross-sectional and a prospective cohort analysis. AU - Farr,Olivia M, AU - Rifas-Shiman,Sheryl L, AU - Oken,Emily, AU - Taveras,Elsie M, AU - Mantzoros,Christos S, Y1 - 2017/06/29/ PY - 2017/06/20/received PY - 2017/06/23/revised PY - 2017/06/23/accepted PY - 2017/8/5/pubmed PY - 2017/10/20/medline PY - 2017/8/5/entrez KW - Cardiometabolic risk KW - Child health KW - Obesity KW - Obstructive sleep apnea KW - Snoring SP - 70 EP - 80 JF - Metabolism: clinical and experimental JO - Metabolism VL - 76 N2 - PURPOSE: Obstructive sleep apnea (OSA), typically manifested as snoring, is closely associated with obesity. However, the directionality of associations of OSA with cardiometabolic risk markers is unclear, as obesity increases risk for OSA, and OSA results in excess weight gain and its metabolic consequences. Less is known about how obesity and OSA may relate in children and adolescents and whether maternal OSA may influence the development of obesity and cardiometabolic dysfunction in offspring. BASIC PROCEDURES: Among 1078 children from the Project Viva cohort, we examined cross-sectionally and prospectively associations of parent-reported child or maternal snoring with cardiometabolic outcomes, including adiposity, adipokines, and insulin resistance. MAIN FINDINGS: Cross-sectionally, child snoring was related to adiposity and metabolic risk, particularly body mass index (BMI; β 0.61kg/m2, 95% CI 0.33, 0.89; p<0.001), trunk fat mass index (β 0.23kg/m2, CI 0.12, 0.34; p<0.001), high-density lipoprotein cholesterol (β -1.47mg/dL, CI -2.69, -0.25; p=0.02), and metabolic risk z-score (β 0.08, CI 0.02, 0.14; p=0.01) after correction for covariates. Prospectively, adiposity (BMI, trunk fat, fat mass, and waist circumference) and cardiometabolic (leptin, HOMA-IR, CRP, and global metabolic risk) measures at mid-childhood (~7y) were associated with child snoring at the early teen visit (~12y) after correction for covariates. Child snoring at ~9y was related to changes in adiposity between mid-childhood and early teen visits. CONCLUSIONS: Child but not maternal snoring, was related to child adiposity and cardiometabolic outcomes. Adiposity and child snoring are associated with each other cross-sectionally and are each predictive of the other among children/adolescents prospectively. These results suggest similar mechanisms in pediatric/adolescent populations as in adults for the development of sleep-disordered breathing and sleep apnea that will need to be confirmed in randomized clinical trials. Importantly, this research points to the need to target both sleep and obesity in order to break this vicious cycle. SN - 1532-8600 UR - https://www.unboundmedicine.com/medline/citation/28774733/Current_child_but_not_maternal_snoring_is_bi_directionally_related_to_adiposity_and_cardiometabolic_risk_markers:_A_cross_sectional_and_a_prospective_cohort_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0026-0495(17)30180-4 DB - PRIME DP - Unbound Medicine ER -