Association between insulin resistance and obstructive sleep apnea in non-diabetic children with obesity
European Journal of Pediatrics, cilt.185, sa.10, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 185 Sayı: 10
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s00431-026-07395-3
- Dergi Adı: European Journal of Pediatrics
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: AHI, Child, Insulin resistance, Sleep apnea
- Hacettepe Üniversitesi Adresli: Evet
Özet
Although several studies have demonstrated an independent association between obstructive sleep apnea (OSA) and insulin resistance, the evidence remains inconsistent. We aimed to investigate the relationship between the presence and severity of OSA and insulin resistance in non-diabetic children with obesity and to explore the potential role of homeostasis model assessment-insulin resistance index (HOMA-IR) in identifying children at higher risk for OSA. Children with obesity aged 6–18 years who underwent polysomnography were retrospectively analyzed. Patients with diabetes, neuromuscular disorders, craniofacial anomalies, or those receiving treatment affecting insulin sensitivity were excluded. Age, sex, BMI, and oral glucose tolerance test (OGTT) results were extracted from medical records, and HOMA-IR was calculated. Patients were divided into two groups based on their obstructive apnea–hypopnea index (OAHI): < 2 and ≥ 2 events/h. ROC analysis was performed for HOMA-IR to determine the optimal cutoff value for identifying patients with OSA. A total of 90 children with obesity were enrolled, among whom 39 (43.3%) had OSA. The groups were comparable in terms of age and sex. Median HOMA-IR values were significantly higher in the OSA group (p = 0.014). Total OAHI showed moderately positive correlation with HOMA-IR (ρ = 0.325, p = 0.002), and baseline insulin levels measured during OGTT (ρ = 0.323, p = 0.002). In multiple linear regression analysis, HOMA-IR remained independently associated with OSA severity after adjustment for age, sex, BMI z-score, sleep efficiency, and pubertal status (β = 0.691, p = 0.025). ROC analysis identified a HOMA-IR cutoff of 3.39, with 72% sensitivity and 59% specificity for OSA. Conclusion: HOMA-IR was independently associated with OSA severity in children with obesity, suggesting that insulin resistance may serve as a useful adjunct marker for identifying patients at higher risk and prioritizing PSG evaluation. (Table presented.)