Epidemiological And Experimental Studies Of Obese Children With Sleep Apnea

Objective:To understand the prevalence and influencing factors of sleep disorders in obese children in Lanzhou.To investigate the role of LXR and its regulatory gene cholesterol ester transporter(CETP)and inflammatory mediator COX2 in OSAHS in obese children,to explore the mechanism of OSAHS in obese children and its association with lipid metabolism disorders,inflammatory response and its possible harm.It will provide scientific theoretical basis for clinical prevention and basic research of sleep disorders in obese children.Method:A stratified cluster random sampling method was used to select 3283primary school students in 4 districts of Lanzhou City.Physical examination and sleep questionnaire were conducted under strict quality control.Children with sleep disorders combined with obesity and obese children combined with sleep disorders were selected from two perspectives as subjects.Obese children with sleep disorders were selected as the experimental group.At the same time,children with normal BMI(age and sex matched with experimental group)were selected as the control group.The two groups of children were routinely examined and biochemical examination,sleep monitoring and the expression levels of LXR,CETP and COX-2 was further measured by real-time quantitative PCR(RT-PCR).Result:The survey showed that the obesity detection rate of primary school students in Lanzhou City was 5.76%,and that of obese children with sleep disorders accounted for42.33%.The incidence of sleep disorders in obese children was significantly higher than that in normal children(x~2=22.71,P<0.01),and 45%of children diagnosed with OSAHS in obese children with sleep disorders.The total incidence of sleep disorders was 16.24%,of which the incidence of sleep disorders was 18.22%for boys and 14.07%for girls.The difference was statistically significant(x~2=10.41,P<0.01).Among children with sleep disorders,24.58%of them met the standard of obesity.There are 11 risk factors for sleep disorders.The total sleeping time among students at primary school was less than 10 h a day in Lanzhou.The sleeping time Was getting shorter and shorter with the growth of total sleeping time.LXR,COX-2,and CETP levels in the OSAHS group were higher than those in the other two groups(P<0.05).COX-2 expression in the group with moderate to severe OSAHS was higher than that in the group with mild OSAHS(t=-3.99,P<0.05).The correlation analysis found that AST,ALT,CHOL,LDL-C and BMI were positively correlated with LXR(P<0.05).Logistic regression analysis showed that AST,ALT,CHOL,BMI,LDL-C were risk factors for LXR>1.The abdominal circumference,abdominal circumference/height(WHtR)and blood pressure of children with obesity and OSAHS were higher than those of normal control group,and were positively correlated with blood pressure of obese children with OSAHS.The rate of abnormal electrocardiogram in obese children with OSAHS was higher than that in the normal control group(x~2=5.160,p<0.05).The moderate to severe body mass index and AHI of OSAHS obese children were higher than the mild group,while LSa02 was lower than the mild group.Obesity children's body mass index was positively correlated with AHI and negatively correlated with LSa02.Conclusion:Child obesity and sleep disorders are highly correlated;the incidence of sleep disorders is higher in boys than in girls;The total sleeping time of the students from primary school in Lanzhou is below the standard national requirements;There is a lower prevalence of sleeping disorders than that in developed city;The main influence factors of the sleeping were the family and social environment,schoolwork burden,Sleep habits,parents'high education and anxiety.LXR gene expression was significantly increased in obese children with OSAHS.The severity of OSAHS was positively correlated with COX-2 levels.Childhood obesity can up-regulate the expression of LXR causing liver damage and lipid metabolism disorders.