Obstructive sleep apnea and metabolic disorders in morbidly obese adolescents

Background: Little known about the prevalence of obstructive sleep apnea (OSA) in morbid obese adolescents and the association between OSA and comorbid factors. Aim: To examine the association between apnea–hypopnea index (AHI, a measure for OSA severity) and metabolic morbidity among morbidly obese adolescents. Methods: We performed a population-based retrospective cohort study by reviewing sleep study, metabolic indices, and comorbidity-related data of a cohort (n = 106) of adolescents referred to a bariatric surgery clinic. We compared subjects with moderate/severe OSA (AHI ≥ 5) versus no/mild OSA (AHI < 5) OSA and three groups of subjects with increasing body mass index (BMI) concerning sleep-study and metabolic indices using univariate analyses. To assess the link between AHI and ferritin levels a multivariate linear regression (adjusted for BMI and mean cell volume) was preformed. Results: A total of 71 patients met the inclusion criteria. Subjects with moderate/severe OSA (n = 32, 45%) had higher BMI, cholesterol, cholesterol/high-density lipoprotein (HDL) ratio, hemoglobin A1c, and serum ferritin levels (p <.05). AHI significantly increased across BMI strata (p =.02). Multivariate linear regression indicated that moderate/severe OSA was associated with higher levels of ferritin, unstandardized β = 49.1 (nIU/ml) (p =.025). Conclusions: Morbidly obese adolescents with moderate/severe OSA versus no/mild OSA have a higher risk for metabolic complications. Therefore, OSA management should be considered in adolescents with morbid obesity, in addition to weight loss.