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Costa M, Correia-Costa L, Santos AC, Azevedo I. Obstructive sleep related breathing disorders and cardiometabolic risk factors - A Portuguese birth cohort. Respir Med 2024; 222:107531. [PMID: 38246393 DOI: 10.1016/j.rmed.2024.107531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Pediatric obstructive sleep related breathing disorders (SRBD) are an important under-diagnosed health problem with associated cardiometabolic comorbidities, demonstrated with polysomnographic studies in selected samples. Our main goal was to assess the prevalence of SRBD in a population-based cohort and to analyze its association with cardiometabolic risk factors, in general and by sex. METHODS Pediatric Sleep Questionnaire (PSQ) was applied to parents of 7-years-old children evaluated in the birth cohort, Generation XXI. Sex, anthropometrics, blood pressure (BP), lipid profile, glucose, insulin, HOMA-IR, and high-sensitivity C-reactive protein were compared among children with/without SRBD, using Chi-square, Mann-Whitney tests and logistic regression models. RESULTS A total of 1931 children (51.2 % boys) were included; 17.5 % were overweight and 15.7 % obese. The prevalence of SRBD was 13.4 %, more frequent among boys (15.7 % vs.10.9 %, p = 0.002) and in overweight/obese children (22.0 % vs.13.6 % vs.11.3 % in obese, overweight and normal weight group, respectively, p < 0.001). Children with SRBD had higher systolic BP (107 ± 8 vs.105±9 mmHg; p = 0.001) and lower HDL-cholesterol levels (54 ± 11 vs.56 ± 11 mg/dL; p = 0.04) than children without SRBD. After adjustment for sex, age, birthweight-for-gestational age and maternal age, children with SRBD had higher BMI-z-score, systolic BP, insulin and HOMA-IR levels, and lower HDL-cholesterol, when compared to those without SRBD, but these associations were lost when adjusting to BMI z-score. Analyzing obese children with the same regression model, those with SRBD presented lower HDL-cholesterol than those without SRBD. CONCLUSIONS Our results identified a male predominance of SRBD in pre-pubertal children and highlighted the potential contribution of SRBD to cardiovascular risk in obese children.
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Affiliation(s)
- Mariana Costa
- Faculty of Medicine, Universidade do Porto, Porto, Portugal; Department of Pediatrics, Centro Hospitalar de Leiria, Portugal
| | - Liane Correia-Costa
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal; Pediatric Nephrology Unit, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal.
| | - Ana Cristina Santos
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Inês Azevedo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal; Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, Universidade do Porto, Porto, Portugal; Clinical Epidemiology, Predictive Medicine and Public Health Department, Faculty of Medicine, Universidade do Porto, Porto, Portugal; Department of Obstetrics-Gynecology and Pediatrics, Faculty of Medicine, Universidade do Porto, Porto, Portugal; Department of Pediatrics, Centro Hospitalar Universitário de São João, Porto, Portugal
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Godoy-Cumillaf A, Fuentes-Merino P, Farías-Valenzuela C, Duclos-Bastías D, Giakoni-Ramírez F, Bruneau-Chávez J, Merellano-Navarro E. The Association between Sedentary Behavior, Physical Activity, and Physical Fitness with Body Mass Index and Sleep Time in Chilean Girls and Boys: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:981. [PMID: 37371213 DOI: 10.3390/children10060981] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND In recent decades, the school population has undergone behavioral changes that have affected their health and adult life. The current educational scenario presents high levels of sedentary behavior, physical inactivity, low physical fitness, high levels of obesity, and non-compliance with sleep recommendations. In Chile, the scientific evidence on associations between these behaviors is incipient. OBJECTIVE To analyze the association between sedentary behavior, physical activity, and physical fitness with BMI and minutes of sleep in Chilean children aged 10 to 11 years. METHODS A non-probabilistic convenience sample of 222 schoolchildren aged 10 to 11 years. The variables measured were body composition (BMI), cardiorespiratory fitness (20 m shuttle run test), lower and upper muscular strength (long jump test and handgrip dynamometry), speed (4 × 10 m running), and flexibility (sit and reach test). Physical activity and sleep were measured by accelerometers. RESULTS Of the participants, 60.4% and 90.6% did not comply with sleep and physical activity recommendations, respectively. Physical fitness was higher in boys in all components. The results of the linear regression show that in girls, moderate-vigorous-intensity physical activity, lower- and upper-body muscular strength, and cardiorespiratory endurance were associated with BMI and sleep. In boys, light-intensity physical activity and upper-body muscular strength were associated with both variables. CONCLUSIONS Physical activity intensity, strength, and cardiorespiratory fitness were associated with BMI and sleep; however, physical activity intensity and associated physical fitness components differed by gender.
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Affiliation(s)
- Andrés Godoy-Cumillaf
- Grupo de Investigación en Educación Física, Salud y Calidad de Vida (EFISAL), Facultad de Educación, Universidad Autónoma de Chile, Temuco 4780000, Chile
| | - Paola Fuentes-Merino
- Grupo de Investigación en Educación Física, Salud y Calidad de Vida (EFISAL), Facultad de Educación, Universidad Autónoma de Chile, Temuco 4780000, Chile
| | | | - Daniel Duclos-Bastías
- School of Physical Education, Universidad Católica de Valparaíso, Valparaíso 2340000, Chile
- IGOID Research Group, Physical Activity and Sport Science Department, University of Castilla-La Mancha, 45071 Toledo, Spain
| | - Frano Giakoni-Ramírez
- Facultad de Educación y Ciencias Sociales, Instituto del Deporte y Bienestar, Universidad Andres Bello, Santiago 7550000, Chile
| | - José Bruneau-Chávez
- Departamento de Educación Física, Deportes y Recreación, Universidad de la Frontera, Temuco 4811230, Chile
| | - Eugenio Merellano-Navarro
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
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Elfaki FA, Mukhayer AIG, Moukhyer ME, Chandika RM, Kremers SPJ. Sleep Duration and Metabolic Syndrome among Early Adolescents-A Cross-Sectional Study in Khartoum State, Sudan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095696. [PMID: 37174213 PMCID: PMC10178036 DOI: 10.3390/ijerph20095696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
Numerous studies have reported that sleep disorders are linked to poor health outcomes. However, studies on these associations in children and adolescents in an African context are limited. The aim of the present study was to analyze the relationship between sleep duration and the presence of metabolic syndrome among early adolescents in Sudan. Methods: A cross-sectional study was conducted on participants aged 10-15 years in Khartoum State, Sudan. Metabolic syndrome (MetS) was diagnosed by increased waist circumference and the presence of two or more metabolic abnormalities (triglycerides [TG], high-density lipoproteins [HDL-C], blood pressure [BP], and fasting plasma glucose [FBG]). Short sleep duration was defined based on National Sleep Foundation (NSF) classification. Data were collected by physical examinations, biochemical analyses, and self-developed standardized questionnaires. Data were analyzed with IBM SPSS Statistics Version 24. A generalized additive model (GAM) was used for the smoothing function between sleep duration and MetS. p < 0.05 was considered as significant. Results: The prevalence of MetS and short sleep among early adolescents aged 10-15 years in Sudan was 2.3% and 55.0%, respectively. A higher prevalence of short sleep was found among overweight and obese participants (p < 0.05). The prevalence of MetS among short sleepers was 2.8%. Binary logistic regression analysis showed that male short sleepers had higher odds of having MetS compared to female short sleepers. The relationship between short sleep and low HDL-C in boys and between short sleep and high TG in girls was statistically significant. The highest risk of MetS was observed at less than 6.5 h of sleep per night. Conclusions: Short sleep duration was significantly associated with overweight/obesity in the total population and with low HDL-C in boys and high triglycerides in girls. A nonlinear curve pattern was observed between sleep duration and prevalence of MetS. Longitudinal studies are needed to further determine the causal relationship between sleep habits and MetS and its components.
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Affiliation(s)
- Fatima A Elfaki
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Jazan University, Jazan P.O. Box 114, Saudi Arabia
- School of Nutrition and Translation Research in Metabolism, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Aziza I G Mukhayer
- Department of Health Education and Promotion, Maastricht University, 6211 LK Maastricht, The Netherlands
- School of Medicine, Ahfad University for Women, Omdurman P.O. Box 167, Sudan
| | - Mohamed E Moukhyer
- Department of Emergency Medical Services, Faculty of Applied Medical Sciences, Jazan University, Jazan P.O. Box 114, Saudi Arabia
- Public Health Programs, School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
| | - Rama M Chandika
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Jazan University, Jazan P.O. Box 114, Saudi Arabia
| | - Stef P J Kremers
- School of Nutrition and Translation Research in Metabolism, Maastricht University, 6211 LK Maastricht, The Netherlands
- Department of Health Education and Promotion, Maastricht University, 6211 LK Maastricht, The Netherlands
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Morales-Ghinaglia N, Fernandez-Mendoza J. Sleep variability and regularity as contributors to obesity and cardiometabolic health in adolescence. Obesity (Silver Spring) 2023; 31:597-614. [PMID: 36754840 PMCID: PMC9975080 DOI: 10.1002/oby.23667] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/17/2022] [Accepted: 11/26/2022] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Adolescence is a developmental stage of critical changes in sleep and its circadian timing when the contribution of abnormal sleep variability (amount) and sleep regularity (timing) to obesity and its associated adverse cardiometabolic health outcomes appears to increase. The aim of this study was to summarize findings from studies conducted in adolescents examining both sleep variability and regularity in relation to obesity and cardiometabolic health. Gaps in research and potential causal pathways that future studies should examine are highlighted. RESULTS Nightly deviations in sleep duration and sleep midpoint appear to contribute to the development of obesity and associated adverse cardiometabolic outcomes in youth. Studies show that increased sleep variability and irregularity are associated with obesity, decreased physical activity, dysregulated eating and inadequate diet, metabolic dysfunction, impaired cardiac autonomic balance, and elevated blood pressure in adolescents. CONCLUSIONS A stable circadian timing of sleep is essential to the overall physical well-being of youth. Emerging evidence supports that sleep variability and circadian misalignment, including sleep irregularity, contribute to adverse obesity-related health outcomes early on in adolescence. Future studies should focus on the underlying behavioral and biological mechanisms in the causal pathway between day-to-day deviations in the amount and timing of sleep and obesity.
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Affiliation(s)
- Natasha Morales-Ghinaglia
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
| | - Julio Fernandez-Mendoza
- Sleep Research & Treatment Center, Department of Psychiatry & Behavioral Health, Penn State University, College of Medicine, Hershey PA 17033
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Liang X, Zhang P, Luo S, Zhang G, Tang X, Liu L. The association of quality of life and personality characteristics with adolescent metabolic syndrome: a cohort study. Health Qual Life Outcomes 2021; 19:160. [PMID: 34103067 PMCID: PMC8186050 DOI: 10.1186/s12955-021-01797-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 06/02/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND An increased prevalence of adolescent metabolic syndrome (MS) is associated with adulthood cardiovascular diseases. This study aimed to explore the potential relationship of quality of life (QoL) and personality traits with adolescent MS. METHODS A total of 1961 participants from Chongqing with an average age of 11.68 years old from a cohort study established in 2014 and followed up through 2019 were included. QoL information, Eysenck's personality questionnaire and MS components were collected. RESULTS A higher QoL domain score of physical activity ability (PAA) was a protective factor for both MS and MS score (all P < 0.01), which was mainly negatively correlated with the MS components of central obesity, diastolic blood pressure (DBP) and triglyceride levels, as well as positively correlated with high density lipoprotein cholesterol (HDL-C) level. The total QoL score was negatively correlated with triglyceride levels and positively correlated with DBP (all P < 0.01). High extraversion personality score was a protective factor against adolescent MS (P = 0.04) and MS score (P < 0.05), which were mainly negatively correlated with the MS components of waist circumference, systolic blood pressure and TGs, and positively correlated with HDL-C (all P ≤ 0.01). CONCLUSIONS QoL score and extraversion personality score were independent protective factors against both MS prevalence and MS score, suggesting that community intervention to improve the QoL and psychological health of children are essential.
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Affiliation(s)
- Xiaohua Liang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, 136 2nd Street, Yuzhong District, Chongqing, 400016, China.
| | - Peng Zhang
- Disease Control and Prevention Center of Jiulongpo District, Chongqing, China
| | - Shunqing Luo
- Medical General Ward of Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Guifang Zhang
- Plastic Surgery Department of Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xian Tang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, 136 2nd Street, Yuzhong District, Chongqing, 400016, China
| | - Lingjuan Liu
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, 136 2nd Street, Yuzhong District, Chongqing, 400016, China
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Liang X, Zhang P, Luo S, Zhang G, Tang X, Liu L. The association of quality of life and personality characteristics with adolescent metabolic syndrome: a cohort study. Health Qual Life Outcomes 2021. [DOI: https://doi.org/10.1186/s12955-021-01797-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
An increased prevalence of adolescent metabolic syndrome (MS) is associated with adulthood cardiovascular diseases. This study aimed to explore the potential relationship of quality of life (QoL) and personality traits with adolescent MS.
Methods
A total of 1961 participants from Chongqing with an average age of 11.68 years old from a cohort study established in 2014 and followed up through 2019 were included. QoL information, Eysenck’s personality questionnaire and MS components were collected.
Results
A higher QoL domain score of physical activity ability (PAA) was a protective factor for both MS and MS score (all P < 0.01), which was mainly negatively correlated with the MS components of central obesity, diastolic blood pressure (DBP) and triglyceride levels, as well as positively correlated with high density lipoprotein cholesterol (HDL-C) level. The total QoL score was negatively correlated with triglyceride levels and positively correlated with DBP (all P < 0.01). High extraversion personality score was a protective factor against adolescent MS (P = 0.04) and MS score (P < 0.05), which were mainly negatively correlated with the MS components of waist circumference, systolic blood pressure and TGs, and positively correlated with HDL-C (all P ≤ 0.01).
Conclusions
QoL score and extraversion personality score were independent protective factors against both MS prevalence and MS score, suggesting that community intervention to improve the QoL and psychological health of children are essential.
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Fitzpatrick JM, Silva GE, Vana KD. Perceived Barriers and Facilitating Factors in Implementing Delayed School Start Times to Improve Adolescent Sleep Patterns. THE JOURNAL OF SCHOOL HEALTH 2020; 91:94-101. [PMID: 33289083 DOI: 10.1111/josh.12983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 08/26/2020] [Accepted: 09/16/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Most adolescents in the United States do not obtain sufficient sleep. Early school start times play a significant role in adolescent sleep deprivation. Most primary and secondary schools begin classes earlier than the 8:30 am. Perceived barriers to implementing a delayed school start time have been suggested in the literature but have not been quantified. This study explored perceived barriers and facilitating factors for implementing delayed high-school start times. METHODS A cross-sectional study. School administrators who had delayed their school start times were invited to complete an online questionnaire ranking the perceived barriers and facilitating factors for implementing the delayed start times. RESULTS Most commonly cited perceived barriers were lack of a tiered bus system, school athletes missing more afternoon classes, and less time after school for athletics. Most commonly cited facilitating factors were school-administrator involvement in the decision-making process and sleep education for family members and school administrators. CONCLUSIONS Participants found that providing sleep education to fellow administrators, teachers, school staff members, families, and students and including them in the decision-making process positively facilitated the implementation of delayed school start times. Perceived barriers to implementation may be overcome with support from stakeholders and planning committees.
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Affiliation(s)
- Julia M Fitzpatrick
- Family Nurse Practitioner, , Benefis Healthcare System, 1101 26th Street South, Great Falls, MT 59405
| | - Graciela E Silva
- Clinical Associate Professor, , The University of Arizona, College of Nursing, 1305 N. Martin, Tucson, AZ 85721
| | - Kimberly D Vana
- Clinical Professor, Arizona State University, Edson College of Nursing and Health Innovation, , 550 North 3rd Street, Phoenix, AZ 85004
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Sun J, Wang M, Yang L, Zhao M, Bovet P, Xi B. Sleep duration and cardiovascular risk factors in children and adolescents: A systematic review. Sleep Med Rev 2020; 53:101338. [DOI: 10.1016/j.smrv.2020.101338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 02/07/2023]
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Fumo-dos-Santos C, Pradella-Hallinan M, Barbisan BN, Tufik S, Moreira GA. Sleep duration on a population of children referred to sleep study - cross-sectional data from 2003 to 2009. Sleep Sci 2019; 12:272-278. [PMID: 32318248 PMCID: PMC7159079 DOI: 10.5935/1984-0063.20190094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Sleep is essential for human beings, especially children. Insufficient sleep is linked to somatic and psychological problems. This study aims to describe nocturnal sleep patterns in children aged 7 to 13 years and investigate if sex or weekdays influence sleep habits. It also analyses factors associated with sleep length and the difference between sleep habits on weekends and weekdays. METHODS A retrospective cross-sectional study with questionnaires from children with sleep complaints referred to our service (December 2003 to June 2009) in Sao Paulo City, Brazil. Median of sleep hours, time going to bed, waking up, and the difference in amount of sleep during weekends and weekdays were calculated. A generalized linear model was used to find associations between covariates and a) sleep hours, and b) sleep weekend minus - weekdays. RESULTS We analyzed 577 children (median 9.5 y, 61% boys). Median bedtime was 22h. Median wake up time was 7h on weekdays and 9h on weekends. Median sleep duration was 9.5h during weekdays and 10h on weekends. The median difference in the amount of sleep during weekends and weekdays was 0.5h (IQR=1.5). Shorter sleep duration was associated with age and school schedule. Higher difference weekend - weekdays was associated with older children, girls, and school schedule. CONCLUSION Children 7 to 13 years usually sleep more on weekends. Age, morning and full-time classes are associated with shorter sleep duration on weekdays and higher weekend-weekdays; girls sleep more during weekends.
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Affiliation(s)
| | | | | | - Sergio Tufik
- Universade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil
| | - Gustavo Antonio Moreira
- Universade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - São Paulo - Brazil., Universade Federal de São Paulo, Departamento de Pediatria - São Paulo - São Paulo - Brazil
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Hemati Z, Mozafarian N, Heshmat R, Ahadi Z, Motlagh ME, Ziaodini H, Taheri M, Aminaee T, Qorbani M, Kelishadi R. Association of sleep duration with metabolic syndrome and its components in children and adolescents; a propensity score-matched analysis: the CASPIAN-V study. Diabetol Metab Syndr 2018; 10:78. [PMID: 30410582 PMCID: PMC6215637 DOI: 10.1186/s13098-018-0381-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 10/24/2018] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the association of sleep duration with metabolic syndrome (MetS) and its components in a pediatric population. METHODS This multi-centric cross-sectional study was conducted in 2015 in 30 provinces of Iran. Participants consisted of 4200 school students aged 7-18 years, studied in a national school-based surveillance program (CASPIAN-V). Physical examinations and laboratory tests were performed using standard protocols. The analysis was conducted based on the propensity score matching and conditional logistic regression was used to evaluate the association of short sleep (less than 8 h a day) and the onset of sleep with MetS and its components. Results of conditional logistic regression was reported as odds ratios (OR) and 95% confidence intervals (CI). RESULTS Overall, 3843 of participants completed the survey (response rate: 91.5%). Their mean (SD) age was 12.3 (3.2) years and 50.6% were boys. In the multivariate model, individuals who slept less than 8 h a day had significantly higher odds of MetS (OR 2.05, 95% CI 1.19-3.63) and high blood pressure (BP) (OR 1.46, 95% CI 1.04-2.06). Association between short sleep duration with other MetS components (including abdominal obesity, hypertriglyceridemia, hyperglycemia, and low levels of high-density lipoprotein-cholesterol was not statistically significant (P > 0.05). Moreover, association between the onset of sleep with MetS and its components was not statistically significant (P > 0.05). CONCLUSION Short sleep duration is associated with increased risk of MetS and high BP in children and adolescents. The clinical impact of current findings should be assessed in future longitudinal studies.
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Affiliation(s)
- Zeinab Hemati
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran
| | - Nafiseh Mozafarian
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Ahadi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hasan Ziaodini
- Office of Health and Fitness, Ministry of Education, Tehran, Iran
| | - Majzoubeh Taheri
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Tahereh Aminaee
- Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar-Jarib Ave, Isfahan, Iran
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Guedes LG, Abreu GDA, Bloch KV. Self-reported nocturnal sleep duration and glycosylated hemoglobin A in the Study of Cardiovascular Risks in Adolescents (ERICA). Sleep Med 2018; 47:60-65. [PMID: 29758395 DOI: 10.1016/j.sleep.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE At present, epidemiologic studies regarding the relationship between sleep duration and glucose metabolism in adolescents are scarce. The objective was to investigate the association between self-reported nocturnal sleep duration and glycosylated hemoglobin A in 12- to 17-year-old Brazilian adolescents. PATIENTS/METHODS A school-based multicenter cross-sectional study was carried out in private and public schools from 273 municipalities with more than 100,000 inhabitants. The final sample comprised 24,923 adolescents. A self-administered questionnaire was used. Blood tests included glucose, insulin, glycosylated hemoglobin A and serum lipids. Age, sex, skin color, school type, body mass index (BMI), physical activity, and Brazilian regions were studied as possible effect modifiers and/or confounders using linear regression. RESULTS A significant positive association was found between more than 12 h of nocturnal sleep and glycosylated hemoglobin A in two Brazilian regions: Southeast and South, even after adjustment for age, sex, skin color, and BMI (coefficients of 0.142 and 0.339, respectively). No association was found with nocturnal sleep duration <7 h. CONCLUSION Notably, a significant positive relationship was found between more than 12 h of nocturnal sleep duration and glycosylated hemoglobin A in two Brazilian regions. The specific pubertal sleep curtailment can be a compensatory mechanism for dealing with the insulin resistance during adolescence. Those that escape from this regulatory strategy and sleep longer than the adequate duration, break down this balance and tend to damage their glucose metabolism. To our knowledge, this is the first large scale study, of the association between sleep duration and glucose metabolism in adolescents.
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Affiliation(s)
- Luciane Gaspar Guedes
- Instituto de Puericultura e Pediatria Martagão Gesteira/Universidade Federal do Rio de Janeiro, Brazil.
| | | | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva/Universidade Federal do Rio de Janeiro, Brazil
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Pulido-Arjona L, Correa-Bautista JE, Agostinis-Sobrinho C, Mota J, Santos R, Correa-Rodríguez M, Garcia-Hermoso A, Ramírez-Vélez R. Role of sleep duration and sleep-related problems in the metabolic syndrome among children and adolescents. Ital J Pediatr 2018; 44:9. [PMID: 29334985 PMCID: PMC5769404 DOI: 10.1186/s13052-018-0451-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/08/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is increasing recognition that sleep is a risk factor for metabolic syndrome (MetS). The aim of the present study was to analyze the relationship between self-reported sleep duration, sleep-related problems and the presence of MetS in children and adolescents from Bogotá, D.C., Colombia. METHODS This is a cross-sectional analysis from the FUPRECOL study (2014-15). Participants included 2779 (54.2% girls) youth from Bogota (Colombia). MetS was defined as the presence of ≥3 of the metabolic abnormalities (hyperglycemia, hypertriglyceridemia, low high-density lipoprotein cholesterol [HDL-c], hypertension, and increased waist circumference) according to the criteria of de Ferranti/Magge and colleges. Self-reported sleep duration and sleep-related problems were assessed with the BEARS questionnaire. RESULTS Logistic regression analysis showed that boys who meet recommended duration of sleep had a decreased risk of elevated blood glucose levels (Odds Ratio [OR] = 0.71, 95%CI [0.40-0.94]; p = 0.031) compared to boys who have short-long sleep duration. Also, compared to young without sleep problems, excessive sleepiness during the day was related to low HDL-c levels in boys (OR = 1.36, 95%CI [1.02-1.83]; p = 0.036) and high triglyceride levels in girls (OR = 1.28, 95%CI [1.01-1.63]; p = 0.045). Girls with irregular sleep patterns had decreased HDL-c levels (OR = 0.71, 95%CI [0.55-0.91]; p = 0.009). CONCLUSIONS Recommended sleep duration was associated with a decreased risk of elevated fasting glucose levels in boys, and sleep problems was related to lower HDL-c in girls and higher triglyceride levels in boys. These findings suggested the clinical importance of improving sleep hygiene to reduce metabolic risk factors in children and adolescents.
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Affiliation(s)
- Leonardo Pulido-Arjona
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
| | - Jorge Enrique Correa-Bautista
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
| | - Cesar Agostinis-Sobrinho
- Research Center in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Jorge Mota
- Research Center in Physical Activity, Health, and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Early Start Research Institute, Faculty of Social Sciences, School of Education, University of Wollongong, Wollongong, Australia
| | | | - Antonio Garcia-Hermoso
- Physical Activity, Sport and Health Sciences Laboratory, Faculty of Medical Sciences, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Robinson Ramírez-Vélez
- Center of Studies in Physical Activity Measurements, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá D.C, Colombia
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Magge SN, Goodman E, Armstrong SC, Daniels S, Corkins M, de Ferranti S, Golden NH, Kim JH, Magge SN, Schwarzenberg SJ, Sills IN, Casella SJ, DeMeglio LA, Gonzalez JL, Kaplowitz PB, Lynch JL, Wintergerst KA, Bolling CF, Armstrong SC, Muth ND, Rausch JC, Rogers VW, Schwartz RP. The Metabolic Syndrome in Children and Adolescents: Shifting the Focus to Cardiometabolic Risk Factor Clustering. Pediatrics 2017; 140:peds.2017-1603. [PMID: 28739653 DOI: 10.1542/peds.2017-1603] [Citation(s) in RCA: 224] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Metabolic syndrome (MetS) was developed by the National Cholesterol Education Program Adult Treatment Panel III, identifying adults with at least 3 of 5 cardiometabolic risk factors (hyperglycemia, increased central adiposity, elevated triglycerides, decreased high-density lipoprotein cholesterol, and elevated blood pressure) who are at increased risk of diabetes and cardiovascular disease. The constellation of MetS component risk factors has a shared pathophysiology and many common treatment approaches grounded in lifestyle modification. Several attempts have been made to define MetS in the pediatric population. However, in children, the construct is difficult to define and has unclear implications for clinical care. In this Clinical Report, we focus on the importance of screening for and treating the individual risk factor components of MetS. Focusing attention on children with cardiometabolic risk factor clustering is emphasized over the need to define a pediatric MetS.
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Affiliation(s)
- Sheela N. Magge
- Division of Endocrinology and Diabetes, and Center for Translational Science, Children's National Health System, Washington, District of Columbia
| | - Elizabeth Goodman
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; and
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14
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Plumptre L, Anderson LN, Chen Y, Carsley S, Narang I, Hamilton J, McCrindle B, Parkin PC, Maguire JL, Birken CS, on behalf of the TARGet Kids! Colla. Longitudinal Analysis of Sleep Duration and Cardiometabolic Risk in Young Children. Child Obes 2017; 13:291-299. [PMID: 30433827 DOI: 10.1089/chi.2016.0279] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The aim of this study is to determine if sleep duration in early childhood is associated with cardiometabolic risk (CMR) in later childhood as assessed by a CMR cluster score [sum of age- and sex-standardized z-scores of waist circumference (WC), systolic blood pressure, triglycerides, glucose, and (inverse) high-density lipoprotein (HDL)]. Secondary objectives included examining sleep duration and the individual CMR factors and BMI z-score. PATIENTS AND METHODS A prospective cohort study was conducted using data from the TARGet Kids! practice-based research network in Toronto, Canada. Children (n = 597) with parent-reported 24-hour sleep duration in early childhood (12-36 months) and a follow-up visit (36-96 months) with all five CMR factors were included in the analysis. Multivariable linear regression was used to assess the relationship between early childhood sleep duration and later childhood CMR, adjusting for relevant covariates. RESULTS Average 24-hour sleep duration in early childhood [mean age: 28.1 (6.6) months] was 11.8 (1.4) hours, with 87% meeting or exceeding total sleep recommendations for their age. Sleep duration in early childhood was not associated with the CMR cluster score in later childhood. Shorter sleep duration was associated with higher HDL concentrations [adjusted β = -0.028 (95% confidence interval: -0.049 to -0.007), p = 0.009]. CONCLUSIONS Further research is needed to determine if early childhood sleep duration is associated with HDL in later childhood. Future studies, which investigate sleep quality in addition to sleep duration, may be helpful.
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Affiliation(s)
- Lesley Plumptre
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada
| | - Laura N Anderson
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,2 Department of Clinical Epidemiology and Biostatistics, McMaster University , Hamilton, Ontario, Canada
| | - Yang Chen
- 3 The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital , Toronto, Ontario, Canada
| | - Sarah Carsley
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,4 Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada
| | - Indra Narang
- 5 Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children , Toronto, Ontario, Canada .,6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada
| | - Jill Hamilton
- 6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada .,7 Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children , Toronto, Ontario, Canada
| | - Brian McCrindle
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,8 Division of Cardiology, Department of Pediatrics, Hospital for Sick Children, University of Toronto , Toronto, Ontario, Canada
| | - Patricia C Parkin
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,4 Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada .,6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada .,9 Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children , Toronto, Ontario, Canada
| | - Jonathon L Maguire
- 3 The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital , Toronto, Ontario, Canada .,4 Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada .,6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada .,10 Department of Pediatrics, St. Michael's Hospital , Toronto, Ontario, Canada
| | - Catherine S Birken
- 1 Child Health Evaluative Sciences, The Hospital for Sick Children , Toronto, Ontario, Canada .,4 Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada .,6 Department of Pediatrics, Faculty of Medicine, University of Toronto , Toronto, Ontario, Canada .,9 Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children , Toronto, Ontario, Canada
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15
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Morita N, Kambayashi I, Okuda T, Oda S, Takada S, Nakajima T, Shide N, Shinkaiya H, Okita K. Inverse Relationship between Sleep Duration and Cardio-Ankle Vascular Index in Children. J Atheroscler Thromb 2017; 24:819-826. [PMID: 27904026 PMCID: PMC5556189 DOI: 10.5551/jat.36517] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/16/2016] [Indexed: 12/22/2022] Open
Abstract
AIM Poor sleep has been shown to be associated with the development of cardiovascular risk factors, such as obesity, in both adults and children. This study aimed to investigate the relationship between sleep duration and arterial stiffness indices in Japanese children and early adolescents. METHODS The data on 102 students (56 males, 46 females; mean age, 11.9±1.8 years) were analyzed. As non-invasive arterial stiffness parameters, the cardio-ankle vascular index (CAVI) and heart-ankle pulse wave velocity (haPWV) were evaluated. Their students' sleep habits (bedtime and wake times on a usual weekday) were investigated using questionnaires, and based on these, their sleep durations were calculated. RESULTS The CAVI values in the males and females were 4.8±0.9 and 4.7±0.9 (arbitrary unit), respectively. haPWV values in the males and females were 5.5±0.6 and 5.4±0.6 m/s, respectively. Sleep duration in the males, but not in the females, was negatively correlated with CAVI (r=-0.356) and haPWV (r=-0.356), suggesting that students with short sleep duration could have increased arterial stiffness. After adjusting for confounders, such as age, sex, systolic blood pressure, heart rate, adiposity, and physical fitness, the correlation of sleep duration with CAVI, but not with haPWV, was still significant (partial r=-0.253, p<0.05). CONCLUSION Our findings suggest that shorter sleep duration influences arterial stiffening even in childhood.
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Affiliation(s)
- Noriteru Morita
- Department of Sport Cultural Studies, Hokkaido University of Education, Iwamizawa, Japan
| | | | - Tomoyasu Okuda
- Department of Sport Cultural Studies, Hokkaido University of Education, Iwamizawa, Japan
| | - Shiro Oda
- Department of Sport Education, Hokusho University, Ebetsu, Japan
| | - Shingo Takada
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Noriyuki Shide
- Department of Sport Cultural Studies, Hokkaido University of Education, Iwamizawa, Japan
| | - Hisashi Shinkaiya
- Department of Sport Cultural Studies, Hokkaido University of Education, Iwamizawa, Japan
| | - Koichi Okita
- Department of Sport Education, Hokusho University, Ebetsu, Japan
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16
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Kaar JL, Simon SL, Schmiege SJ, Nadeau KJ, Kelsey MM. Adolescent's Health Behaviors and Risk for Insulin Resistance: A Review of the Literature. Curr Diab Rep 2017; 17:49. [PMID: 28526994 DOI: 10.1007/s11892-017-0881-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW One-third of US adolescents are obese, and related comorbidities exist in this population. Preventing early indicators of these diseases, such as insulin resistance (IR), may impact future morbidity and mortality. Interventions to date have only focused on diet or exercise. Additional targets to prevent disease are needed. This paper reviews the evidence in adolescents examining multiple health behaviors that have been associated with IR. RECENT FINDINGS Health behaviors (i.e., diet, activity, sleep) have been individually examined as possible contributors to disease, but an understanding of the complex interplay between these behaviors is lacking. A better understanding of how multiple health behaviors contribute to IR in adolescents is needed. Future studies using both advanced statistical methodology and robust measures of each health behavior may facilitate better understanding of the impact of lifestyle factors on IR and guide intervention strategies to reduce the risk of disease.
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Affiliation(s)
- Jill L Kaar
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA.
| | - Stacey L Simon
- Department of Pediatrics, Division of Pulmonology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 395, Aurora, CO, 80045, USA
| | - Sarah J Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13120 East 19th Avenue, Mail Stop C288-04, Aurora, CO, 80045, USA
| | - Kristen J Nadeau
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA
| | - Megan M Kelsey
- Department of Pediatrics, Division of Pediatric Endocrinology, Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Box 265, Aurora, CO, 80045, USA
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17
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Abstract
Subspecialty pediatric practice provides comprehensive medical care for a range of ages, from premature infants to children, and often includes adults with complex medical and surgical issues that warrant multidisciplinary care. Normal physiologic variations involving different body systems occur during sleep and these vary with age, stage of sleep, and underlying health conditions. This article is a concise review of the cardiovascular (CV) physiology and pathophysiology in children, sleep-disordered breathing (SDB) contributing to CV morbidity, congenital and acquired CV pathology resulting in SDB, and the relationship between SDB and CV morbidity in different clinical syndromes and systemic diseases in the expanded pediatric population.
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Affiliation(s)
- Grace R Paul
- Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA.
| | - Swaroop Pinto
- Division of Pulmonary and Sleep Medicine, Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA
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18
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Forrestel AC, Miedlich SU, Yurcheshen M, Wittlin SD, Sellix MT. Chronomedicine and type 2 diabetes: shining some light on melatonin. Diabetologia 2017; 60:808-822. [PMID: 27981356 DOI: 10.1007/s00125-016-4175-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/18/2016] [Indexed: 12/19/2022]
Abstract
In mammals, the circadian timing system drives rhythms of physiology and behaviour, including the daily rhythms of feeding and activity. The timing system coordinates temporal variation in the biochemical landscape with changes in nutrient intake in order to optimise energy balance and maintain metabolic homeostasis. Circadian disruption (e.g. as a result of shift work or jet lag) can disturb this continuity and increase the risk of cardiometabolic disease. Obesity and metabolic disease can also disturb the timing and amplitude of the clock in multiple organ systems, further exacerbating disease progression. As our understanding of the synergy between the timing system and metabolism has grown, an interest has emerged in the development of novel clock-targeting pharmaceuticals or nutraceuticals for the treatment of metabolic dysfunction. Recently, the pineal hormone melatonin has received some attention as a potential chronotherapeutic drug for metabolic disease. Melatonin is well known for its sleep-promoting effects and putative activity as a chronobiotic drug, stimulating coordination of biochemical oscillations through targeting the internal timing system. Melatonin affects the insulin secretory activity of the pancreatic beta cell, hepatic glucose metabolism and insulin sensitivity. Individuals with type 2 diabetes mellitus have lower night-time serum melatonin levels and increased risk of comorbid sleep disturbances compared with healthy individuals. Further, reduced melatonin levels, and mutations and/or genetic polymorphisms of the melatonin receptors are associated with an increased risk of developing type 2 diabetes. Herein we review our understanding of molecular clock control of glucose homeostasis, detail the influence of circadian disruption on glucose metabolism in critical peripheral tissues, explore the contribution of melatonin signalling to the aetiology of type 2 diabetes, and discuss the pros and cons of melatonin chronopharmacotherapy in disease management.
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Affiliation(s)
- Andrew C Forrestel
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 693, Rochester, NY, 14642, USA
| | - Susanne U Miedlich
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 693, Rochester, NY, 14642, USA
| | - Michael Yurcheshen
- UR Medicine Sleep Center, Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Steven D Wittlin
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 693, Rochester, NY, 14642, USA
| | - Michael T Sellix
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 693, Rochester, NY, 14642, USA.
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19
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Isacco L, Roche J, Quinart S, Thivel D, Gillet V, Nègre V, Mougin F. Cardiometabolic risk is associated with the severity of sleep-disordered breathing in children with obesity. Physiol Behav 2016; 170:62-67. [PMID: 27993515 DOI: 10.1016/j.physbeh.2016.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 12/15/2016] [Accepted: 12/15/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND The alarming progression of pediatric obesity is associated with the development of sleep-disordered breathing (SDB), and both exhibit similar adverse cardiometabolic health outcomes. Physical activity level (PAL) may counteract sleep and metabolic disturbances. The present study investigates i) the association between the metabolic syndrome in childhood obesity and SDB, ii) the impact of SDB severity on cardiometabolic risk scores and PAL in children with obesity. METHODS Maturation status (Tanner stages), anthropometric (height, weight, body mass index, waist circumference, body adiposity index) and cardiometabolic characteristics (systolic and diastolic blood pressure, lipid and glycemic profiles) were assessed in 83 obese children (mean±SD, age: 10.7±2.7years). PAL and SDB were investigated with a step test and interviews, and an overnight sleep monitor, respectively. The presence or absence of metabolic syndrome (MS) was established and continuous cardiometabolic risk scores were calculated (MetScoreBMI and MetScoreWC). RESULTS Obese children with (61.4%) and without (38.6%) MS present similar SDB. SDB severity is associated with increased insulin concentrations, MetScoreBMI and MetScoreWC (p<0.05) in obese children. There is no association between SDB and PAL. CONCLUSIONS In a context where no consensus exists for SDB diagnosis in children, our results suggest the influence of SDB severity on cardiometabolic risk factors. Further studies are needed to explore the association between PAL and both metabolic and sleep alterations in obese children.
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Affiliation(s)
- Laurie Isacco
- EA3920, Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comte, France, CHRU Jean Minjoz. Boulevard Fleming, F-25000 Besançon, France; Sports Science Faculty, University of Bourgogne Franche-Comte, France, 31 chemin de l'Epitaphe. F-25000 Besançon, France.
| | - Johanna Roche
- EA3920, Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comte, France, CHRU Jean Minjoz. Boulevard Fleming, F-25000 Besançon, France; Sports Science Faculty, University of Bourgogne Franche-Comte, France, 31 chemin de l'Epitaphe. F-25000 Besançon, France; Sleep and Health Medicine Center, Franois, France, Ellipse. 9 chemin des quatre Journaux, 25770 Franois, France.
| | - Sylvain Quinart
- EA3920, Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comte, France, CHRU Jean Minjoz. Boulevard Fleming, F-25000 Besançon, France; Pediatric Obesity Prevention and Rehabilitation Department, Besançon, France, RéPPOP-FC-CHRU St Jacques, 2 place St Jacques, F-25000, Besançon cedex, France.
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UE3533, Clermont Auvergne University, Clermont-Ferrand, Campus Universitaire des Cézeaux, 5 impasse Amélie Murat, 63178 Aubière cedex, France; Auvergne Research Center for Human Nutrition (CRNH), 58 Rue Montalembert, 63009 Clermont-Ferrand, France.
| | - Valérie Gillet
- Sleep and Health Medicine Center, Franois, France, Ellipse. 9 chemin des quatre Journaux, 25770 Franois, France.
| | - Véronique Nègre
- Pediatric Obesity Prevention and Rehabilitation Department, Besançon, France, RéPPOP-FC-CHRU St Jacques, 2 place St Jacques, F-25000, Besançon cedex, France.
| | - Fabienne Mougin
- EA3920, Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comte, France, CHRU Jean Minjoz. Boulevard Fleming, F-25000 Besançon, France; Sports Science Faculty, University of Bourgogne Franche-Comte, France, 31 chemin de l'Epitaphe. F-25000 Besançon, France.
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20
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Hart CN, Hawley NL, Wing RR. Development of a Behavioral Sleep Intervention as a Novel Approach for Pediatric Obesity in School-aged Children. Sleep Med Clin 2016; 11:515-523. [PMID: 28118874 PMCID: PMC5425948 DOI: 10.1016/j.jsmc.2016.08.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Despite being the focus of widespread public health efforts, childhood obesity remains an epidemic worldwide. Given the now well-documented consequences of obesity for childhood health and psychosocial functioning, as well as associated morbidity in adulthood, identifying novel, modifiable behaviors that can be targeted to improve weight control is imperative. Enhancing children's sleep may show promise in assisting with weight regulation. The present paper describes the development of a brief behavioral sleep intervention for school-aged children, including preliminary findings of this work as well as areas for future study.
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Affiliation(s)
- Chantelle N Hart
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 North Broad Street, Philadelphia, PA 19140, USA.
| | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA
| | - Rena R Wing
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital, Alpert Medical School of Brown University, 196 Richmond Street, Providence, RI 02903, USA
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21
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Quist JS, Sjödin A, Chaput JP, Hjorth MF. Sleep and cardiometabolic risk in children and adolescents. Sleep Med Rev 2016; 29:76-100. [DOI: 10.1016/j.smrv.2015.09.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 12/22/2022]
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22
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Kuula L, Pesonen AK, Kajantie E, Lahti J, Andersson S, Strandberg T, Räikkönen K. Sleep and Lipid Profile During Transition from Childhood to Adolescence. J Pediatr 2016; 177:173-178.e1. [PMID: 27453369 DOI: 10.1016/j.jpeds.2016.06.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/04/2016] [Accepted: 06/08/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To assess the longitudinal effects of sleep duration and quality on lipid profiles during the transition from childhood to early adolescence, over a 4-year-period. STUDY DESIGN A cohort study of children born in 1998 examined at 8 years of age (SD, 0.3; n = 105) and 12 years of age (SD, 0.5; n = 190). Sleep duration, wake after sleep onset, sleep efficiency, and weekend catch-up sleep were measured with actigraphs for 7 (8 years of age) and 8 (12 years of age) nights. Fasting serum samples were collected at 12 years of age. Covariates included age, pubertal development, socioeconomic status, body mass index, and physical activity. RESULTS In girls, shorter sleep duration at 8 and 12 years of age was associated with lower high-density lipoprotein-cholesterol and higher triglycerides at 12 years of age. Poorer sleep quality at 8 years of age and longer weekend catch-up sleep at 12 years of age was associated with higher triglycerides at 12 years of age. From 8 to 12 years of age, improvement in sleep quality associated with higher total cholesterol, and a decrease in sleep duration with lower lipid levels. In boys, longer sleep duration at 8 years of age, and a larger decrease in sleep duration from 8 to 12 years of age was associated with higher levels of triglycerides at 12 years of age. CONCLUSIONS Poorer sleep during transition to early adolescence is associated with an atherogenic lipid profile in early adolescent girls, and such effects are less prominent in boys. Poor sleep may have long-term associations with health, which are not mitigated by the amount of physical activity.
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Affiliation(s)
- Liisa Kuula
- Institute of Behavioral Sciences, University of Helsinki, Finland.
| | | | - Eero Kajantie
- Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland; Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland; Department of Obstetrics and Gynecology, MRC Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Jari Lahti
- Institute of Behavioral Sciences, University of Helsinki, Finland; Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Timo Strandberg
- University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland; Center for Life Course Epidemiology and Systems Medicine, University of Oulu, Oulu, Finland
| | - Katri Räikkönen
- Institute of Behavioral Sciences, University of Helsinki, Finland
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23
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Sayin FK, Buyukinan M. Sleep Duration and Media Time Have a Major Impact on Insulin Resistance and Metabolic Risk Factors in Obese Children and Adolescents. Child Obes 2016; 12:272-8. [PMID: 26978730 DOI: 10.1089/chi.2015.0126] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Lifestyle factors sleep duration and media time during childhood differ between countries. This study examined whether sleep duration and media time affect metabolic risk factors insulin resistance (IR), blood lipid profile, and liver enzymes, and whether there is a relationship between sleep time and media time in Turkish obese children and adolescents. METHODS Subjects included 108 obese children and adolescents (aged 10-15 years) whose lifestyle factors were assessed using a survey containing questions about sleep durations, television viewing, media use, and demographic factors. Metabolic risk factors were compared among groups categorized according to sleep and media duration. RESULTS Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and triglyceride (TG) levels and homeostasis model assessment of insulin resistance (HOMA-IR) values were higher in subjects who spent >5 hours/day on media. Children 10-13 years old who slept <9 hours/day were more likely to have higher insulin and HOMA-IR (p < 0.05) levels and lower high-density lipoprotein cholesterol (HDL-C) levels compared with subjects who slept 9-10 hours/day and >10 hours/day. Correlation analysis revealed a negative relationship between sleep time and media time (r = -0.471, p = 0.000). CONCLUSIONS Short sleep duration was associated with IR and an elevated plasma lipoprotein profile in children and adolescents. Our results suggest that insufficient sleep and excessive media exposure may contribute to metabolic risk in the context of obesity, and therefore, working to improve sleep duration and limit media time could help reduce metabolic risk in obese children and adolescents.
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Affiliation(s)
- Fatma Kubra Sayin
- 1 Department of Nutrition and Dietetics, Faculty of Health Sciences, Necmettin Erbakan University , Konya, Turkey
| | - Muammer Buyukinan
- 2 Department of Paediatric Endocrinology, Konya Training and Research Hospital , Konya, Turkey
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Strambi M, Giussani M, Ambruzzi MA, Brambilla P, Corrado C, Giordano U, Maffeis C, Maringhin S, Matteucci MC, Menghetti E, Salice P, Schena F, Strisciuglio P, Valerio G, Viazzi F, Virdis R, Genovesi S. Novelty in hypertension in children and adolescents: focus on hypertension during the first year of life, use and interpretation of ambulatory blood pressure monitoring, role of physical activity in prevention and treatment, simple carbohydrates and uric acid as risk factors. Ital J Pediatr 2016; 42:69. [PMID: 27423331 PMCID: PMC4947361 DOI: 10.1186/s13052-016-0277-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 07/05/2016] [Indexed: 02/07/2023] Open
Abstract
The present article intends to provide an update of the article "Focus on prevention, diagnosis and treatment of hypertension in children and adolescents" published in 2013 (Spagnolo et al., Ital J Pediatr 39:20, 2013) in this journal. This revision is justified by the fact that during the last years there have been several new scientific contributions to the problem of hypertension in pediatric age and during adolescence. Nevertheless, for what regards some aspects of the previous article, the newly acquired information did not require substantial changes to what was already published, both from a cultural and from a clinical point of view. We felt, however, the necessity to rewrite and/or to extend other parts in the light of the most recent scientific publications. More specifically, we updated and extended the chapters on the diagnosis and management of hypertension in newborns and unweaned babies, on the use and interpretation of ambulatory blood pressure monitoring, and on the usefulness of and indications for physical activity. Furthermore, we added an entirely new section on the role that simple carbohydrates (fructose in particular) and uric acid may play in the pathogenesis of hypertension in pediatric age.
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Affiliation(s)
- Mirella Strambi
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Dipartimento di Biologia Molecolare e dello Sviluppo, Università di Siena, Siena, Italy
| | - Marco Giussani
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy. .,ASL Milano 1, Novate Milanese Ollearo 2, 20155, Milan, Italy.
| | | | | | - Ciro Corrado
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,UOC Nefrologia Pediatrica A.R.N.A.S. Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Ugo Giordano
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Alta Specializzazione Ipertensione Arteriosa, UOS Medicina dello Sport, Dipartimento Medico-Chirurgico di Cardiologia Pediatrica, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Claudio Maffeis
- UOC Pediatria ad Indirizzo Dietologico e Malattie del Metabolismo Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Silvio Maringhin
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,UOC Nefrologia Pediatrica A.R.N.A.S. Civico, Di Cristina e Benfratelli, Palermo, Italy.,Società Italiana Nefrologia Pediatrica, Milan, Italy
| | - Maria Chiara Matteucci
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy
| | - Ettore Menghetti
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy
| | - Patrizia Salice
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Cardiologia Perinatale e Pediatrica, UOC Malattie Cardiovascolari, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Società Italiana Cardiologia Pediatrica, Florence, Italy
| | - Federico Schena
- Neonatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pietro Strisciuglio
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Dipartimento di Scienze Mediche Translazionali, Università Federico II Napoli, Naples, Italy
| | - Giuliana Valerio
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Naples, Italy
| | - Francesca Viazzi
- Dipartimento di Medicina Interna, Università di Genova e IRCCS AOU San Martino-IST, Genoa, Italy
| | - Raffaele Virdis
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Dipartimento Scienze Biomediche, Biotecnologiche e Traslazionali - S.Bi.Bi.T. Università di Parma, Parma, Italy
| | - Simonetta Genovesi
- Dipartimento di Medicina e Chirurgia, Università di Milano Bicocca, Monza, Italy.,Dipartimento di Scienze Cardiovascolari, Neurologiche e Metaboliche, Ospedale S. Luca, IRCCS, Istituto Auxologico Italiano, Milan, Italy.,Società Italiana Ipertensione Arteriosa, Milan, Italy
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Hart CN, Hawley NL, Wing RR. Development of a Behavioral Sleep Intervention as a Novel Approach for Pediatric Obesity in School-aged Children. Pediatr Clin North Am 2016; 63:511-23. [PMID: 27261547 PMCID: PMC4893806 DOI: 10.1016/j.pcl.2016.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Despite being the focus of widespread public health efforts, childhood obesity remains an epidemic worldwide. Given the now well-documented consequences of obesity for childhood health and psychosocial functioning, as well as associated morbidity in adulthood, identifying novel, modifiable behaviors that can be targeted to improve weight control is imperative. Enhancing children's sleep may show promise in assisting with weight regulation. The present paper describes the development of a brief behavioral sleep intervention for school-aged children, including preliminary findings of this work as well as areas for future study.
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Affiliation(s)
- Chantelle N. Hart
- Center for Obesity Research and Education and Department of Social and Behavioral Sciences, College of Public Health, Temple University
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University
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26
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Peterson MD, Zhang P, Saltarelli WA, Visich PS, Gordon PM. Low Muscle Strength Thresholds for the Detection of Cardiometabolic Risk in Adolescents. Am J Prev Med 2016; 50:593-599. [PMID: 26585050 DOI: 10.1016/j.amepre.2015.09.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/14/2015] [Accepted: 09/21/2015] [Indexed: 01/11/2023]
Abstract
INTRODUCTION There is an association between strength and health among adolescents, yet, what remains to be determined is sex-specific cut points for low strength in the detection of risk in this population. The purpose of this study was to determine thresholds of low grip strength in a large cohort (N=1,326) of adolescents. METHODS All data were collected between 2005 and 2008, and analyzed in 2014-2015. A cardiometabolic risk score (MetScore) was computed from the following components: percent body fat, fasting glucose, blood pressure, plasma triglyceride levels, and high-density lipoprotein cholesterol. A high-risk cardiometabolic phenotype was characterized as ≥75th percentile of the MetScore. Conditional inference tree analyses were used to identify sex-specific, low normalized strength (grip strength/body mass) thresholds and risk categories. RESULTS Lower strength was independently associated with increased odds of the high-risk cardiometabolic phenotype, such that for every 5% decrement of normalized strength, there were 1.48 and 1.45 increased odds (p<0.001) for boys and girls, even after adjusting for cardiorespiratory fitness and physical activity. Conditional tree analysis revealed a high-risk threshold for boys (≤0.33) and girls (≤0.28), as well as an intermediate threshold (boys, >0.33 and ≤0.45; girls, >0.28 and ≤0.36). CONCLUSIONS These sex-specific thresholds of low strength can be incorporated into a clinical setting for identifying adolescents that would benefit from lifestyle interventions to improve muscular fitness and reduce cardiometabolic risk.
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Affiliation(s)
- Mark D Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan
| | - Peng Zhang
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - William A Saltarelli
- Human Performance Laboratory, Central Michigan University, Mt. Pleasant, Michigan
| | - Paul S Visich
- Exercise and Sport Performance Department, University of New England, Portland, Maine
| | - Paul M Gordon
- Department of Health, Human Performance and Recreation, Baylor University, Waco, Texas.
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27
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Longitudinal differences in sleep duration in Hispanic and Caucasian children. Sleep Med 2015; 18:61-6. [PMID: 26299467 DOI: 10.1016/j.sleep.2015.06.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 04/29/2015] [Accepted: 06/16/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIM Short sleep duration is associated with significant negative consequences, including poor school performance, behavioral problems, obesity, and hypertension. There is prior evidence that there are disparities in sleep duration related to ethnicity; however, there are no specific data on Hispanic children. We aimed to test the hypothesis that there are ethnic differences in parent-reported sleep duration in a community-based cohort of Hispanic and Caucasian children. METHODS We examined the parent-reported sleep patterns of a community-based prospective cohort (Tucson Children's Assessment of Sleep Apnea study [TuCASA]) involving 338 Hispanic and Caucasian children at two time points approximately five years apart. RESULTS In the initial phase of the TuCASA study with a cohort median age of 8.8 years (interquartile range (IQR), 7.6-10.1 years), parent-reported sleep duration during weekdays was shorter in Hispanic (median, 9.5 h; IQR, 9.0, 10.0 years) than in Caucasian children (10 h; IQR, 9.5, 10.0 h; p < 0.0001); however, this difference was not seen 5 years later when the cohort was older (median age, 13.3 years; IQR, 11.9-14.6 years; p = 0.43). In addition, Hispanic children had a significantly later bedtime at both time points (p < 0.02). In the initial phase, parent-reported sleep duration during weekends tended to be shorter in Hispanic than in Caucasian children (p = 0.06). CONCLUSIONS Short sleep duration in Hispanic children may contribute to health disparities. Our research suggests that in Hispanic children, behavioral interventions toward improving sleep duration accomplished by earlier bedtimes or delayed school start times and mechanistic studies to unravel any inherent tendency toward a delayed sleep phase are needed.
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28
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Matthews KA, Pantesco EJM. Sleep characteristics and cardiovascular risk in children and adolescents: an enumerative review. Sleep Med 2015; 18:36-49. [PMID: 26459685 DOI: 10.1016/j.sleep.2015.06.004] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 04/23/2015] [Accepted: 06/01/2015] [Indexed: 01/10/2023]
Abstract
Cardiovascular risk factors develop in childhood and adolescence. This enumerative review addresses whether sleep characteristics, including sleep duration, continuity, quality, and daytime sleepiness, are associated with cardiovascular risk factors in young people. Thirty-nine studies were identified, which examined the following risk factors: metabolic syndrome, glucose and insulin, lipids, blood pressure, and cardiovascular responses to psychological stressors. Due to the availability of other reviews, 16 longitudinal studies of obesity published in 2011 and later were also included in this report. Excluded from the review were studies of participants with suspected or diagnosed sleep disorders and reports from sleep deprivation experiments. Combining studies, evidence was strongest for obesity, followed by glucose, insulin, blood pressure (especially ambulatory blood pressure), and parasympathetic responses to psychological stressors. There was little evidence for metabolic syndrome cluster, lipids, and blood pressure responses to psychological stressors. The more positive associations were obtained for studies that incorporated objective measures of sleep and that included adolescents. The foundational evidence is almost entirely cross-sectional, except for work on obesity. In summary, available evidence suggests that the associations between sleep characteristics and cardiovascular risk vary by risk factor. It is time to conduct studies to determine antecedent and consequent relationships, and to expand risk factors to include markers of inflammation.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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29
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Hakim F, Kheirandish-Gozal L, Gozal D. Obesity and Altered Sleep: A Pathway to Metabolic Derangements in Children? Semin Pediatr Neurol 2015; 22:77-85. [PMID: 26072337 PMCID: PMC4466552 DOI: 10.1016/j.spen.2015.04.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Obstructive sleep apnea (OSA) is a frequent disorder in children and is primarily associated with adenotonsillar hypertrophy. The prominent increases in childhood overweight and obesity rates in the world even among youngest of children have translated into parallel increases in the prevalence of OSA, and such trends are undoubtedly associated with deleterious global health outcomes and life expectancy. Even an obesity phenotype in childhood OSA, more close to the adult type, has been recently proposed. Reciprocal interactions between sleep in general, OSA, obesity, and disruptions of metabolic homeostasis have emerged in recent years. These associations have suggested the a priori involvement of complex sets of metabolic and inflammatory pathways, all of which may underlie an increased risk for increased orexigenic behaviors and dysfunctional satiety, hyperlipidemia, and insulin resistance that ultimately favor the emergence of metabolic syndrome. Here, we review some of the critical evidence supporting the proposed associations between sleep disruption and the metabolism-obesity complex. In addition, we describe the more recent evidence linking the potential interactive roles of OSA and obesity on metabolic phenotype.
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Affiliation(s)
- Fahed Hakim
- Pediatric Pulmonary Institute, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Leila Kheirandish-Gozal
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
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Husain SS, Kalinin A, Truong A, Dinov ID. SOCR data dashboard: an integrated big data archive mashing medicare, labor, census and econometric information. JOURNAL OF BIG DATA 2015; 2:13. [PMID: 26236573 PMCID: PMC4520712 DOI: 10.1186/s40537-015-0018-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 06/01/2015] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Intuitive formulation of informative and computationally-efficient queries on big and complex datasets present a number of challenges. As data collection is increasingly streamlined and ubiquitous, data exploration, discovery and analytics get considerably harder. Exploratory querying of heterogeneous and multi-source information is both difficult and necessary to advance our knowledge about the world around us. RESEARCH DESIGN We developed a mechanism to integrate dispersed multi-source data and service the mashed information via human and machine interfaces in a secure, scalable manner. This process facilitates the exploration of subtle associations between variables, population strata, or clusters of data elements, which may be opaque to standard independent inspection of the individual sources. This a new platform includes a device agnostic tool (Dashboard webapp, http://socr.umich.edu/HTML5/Dashboard/) for graphical querying, navigating and exploring the multivariate associations in complex heterogeneous datasets. RESULTS The paper illustrates this core functionality and serviceoriented infrastructure using healthcare data (e.g., US data from the 2010 Census, Demographic and Economic surveys, Bureau of Labor Statistics, and Center for Medicare Services) as well as Parkinson's Disease neuroimaging data. Both the back-end data archive and the front-end dashboard interfaces are continuously expanded to include additional data elements and new ways to customize the human and machine interactions. CONCLUSIONS A client-side data import utility allows for easy and intuitive integration of user-supplied datasets. This completely open-science framework may be used for exploratory analytics, confirmatory analyses, meta-analyses, and education and training purposes in a wide variety of fields.
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Affiliation(s)
- Syed S Husain
- Statistics Online Computational Resource (SOCR), UMSN, 400 N. Ingalls Health Behavior and Biological Sciences Prechter Bipolar Research Fund Michigan Institute for Data Science University of Michigan, Ann Arbor, MI 48109 USA
| | - Alexandr Kalinin
- Statistics Online Computational Resource (SOCR), UMSN, 400 N. Ingalls Health Behavior and Biological Sciences Prechter Bipolar Research Fund Michigan Institute for Data Science University of Michigan, Ann Arbor, MI 48109 USA
| | - Anh Truong
- Statistics Online Computational Resource (SOCR), UMSN, 400 N. Ingalls Health Behavior and Biological Sciences Prechter Bipolar Research Fund Michigan Institute for Data Science University of Michigan, Ann Arbor, MI 48109 USA
| | - Ivo D Dinov
- Statistics Online Computational Resource (SOCR), UMSN, 400 N. Ingalls Health Behavior and Biological Sciences Prechter Bipolar Research Fund Michigan Institute for Data Science University of Michigan, Ann Arbor, MI 48109 USA
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Abstract
OBJECTIVE Overweight/obesity prevalence has increased dramatically worldwide. Recent evidence suggests sleep deprivation/fragmentation, fructose-exceedingly rich diets, and exposure to endocrine disruptors (eg, bisphenol A, BPA) as emerging additional factors involved in pathomechanisms and in the treatment resistance of obesity and its complications. Our study focuses on these factors for further preventive/therapeutic approaches in paediatric obesity. METHODS Fifty-four Italian children (cases: n = 31 overweight/obese; controls: n = 23 normal weight) were clinically/anthropometrically characterised. Parents completed questionnaires on the relation between obesogenic factors and childhood obesity. BPA was measured by gas chromatography/tandem mass spectrometry on early morning urine samples. Correlations between the continuous variables were analysed using Spearman rank correlation. RESULTS Sleep deprivation/fragmentation, nocturnal breathing problems, and daytime sleepiness increased with increasing body mass index, correlating with the presence of clinical markers of metabolic syndrome (eg, acanthosis nigricans). Frequency of sugar-enriched drink consumption and the amount of fructose per portion and/or per week increased, paralleling the ponderal excess and all the other anthropometric parameters. In the entire sample population, free and total BPA levels increased paralleling the body mass index increase (r > 0.8), whereas the conjugate demonstrated the opposite trend. The re-use of disposable plastic showed a positive correlation with urinary BPA levels. CONCLUSIONS Despite its exploratory nature, the results of our pilot study confirm the close relation between certain factors and paediatric obesity, underscoring their role as emerging targets for prevention and therapy.
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