Impact of obstructive sleep apnea and obesity on endothelial dysfunction in children

2020 
Background: Endothelial dysfunction in children can arise in the context of both obesity and obstructive sleep apnea (OSA). The interactions between these variables together is not clearly understood. Aims and Objectives: To investigate the effect of weight loss on endothelial function and OSA in an obese population and whether a change in endothelial function can be linked to an improvement in OSA? Methods: Children aged 8 to 18 in a 12 month inpatient weight loss program at Zeepreventorium De Haan were recruited. Anthropometry and endothelial function (measured as time to peak response (TPR) by EndoPAT) were collected at baseline, at 12 and at 18 months. At baseline a sleep screening with ApneaLink was performed. This was repeated after 12 months in the presence of OSA. Results: 130 children were included of which 87 had OSA (67%). Only 71 and 28 patients attended follow-up at 12 and 18 months. After 12 months, 10 patients had residual OSA (treatment succes rate of 78.7%). Weight parameters decreased after 12 months (from an average of 2.7 BMI z score to 1.7; p Conclusions: Weight loss improves endothelial function in an obese pediatric population. However, even after weight loss, endothelial function is less likely to improve in the presence of OSA. *p values between baseline and 18 months
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