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Sleep-disordered breathing and uric acid in overweight and obese children and adolescents

¹ Department of Pediatrics, Antwerp University Hospital, Belgium ² Department of Diabetology, Metabolism and Clinical Nutrition, Antwerp University Hospital, Belgium ³ Department of Respiratory Medicine, Antwerp University Hospital, Belgium

stijn.verhulst{at}ua.ac.be

Abstract

ObjectiveThe aim of this study was to determine whether the severity of sleep-disordered breathing (SDB) was associated with increased uric acid (UA) both in serum and in urine, as a marker of tissue hypoxia, in a sample of overweight and obese subjects, irrespective of indices of adiposity.

MethodsConsecutive subjects underwent polysomnography, fasting blood sampling and 24-hour urine collection. Outcome parameters were serum UA, UA excretion ((24h-urinary UA x serum creatinine)/urine creatinine) and urinary UA/creatinine ratio.

Results93 subjects were included (44% boys; <age> = 11.1±2.5; 73% obese). A fasting measurement of serum UA was available for 62 patients. Respiratory disturbance index was a significant covariate (ß = 0.09±0.03; p = 0.01) in the regression model for serum UA, controlling for sex (ß = 0.32±0.29; p = 0.3), puberty (ß = 0.87±0.34; p = 0.01) and waist circumference (ß = 0.04±0.01; p = 0.005). % of total sleep time with SaO2 89% (ß = 0.94±0.45; p = 0.04) was also significantly associated with serum UA, controlling for sex (0.22±0.30; p = 0.5), puberty (0.83±0.35; p = 0.02) and waist circumference (0.04±0.02; p = 0.02). None of the SDB variables correlated with UA excretion or with urinary UA/creatinine ratio

Conclusionthis study in overweight children and adolescents demonstrated a relationship between the severity of sleep apnea and increased levels of serum UA, independent of abdominal adiposity. In view of the known associations between UA and cardiovascular risk, this finding may contribute to the mechanisms linking SDB with cardiovascular morbidity.

Key Words: adolescence • childhood • obesity • sleep-disordered breathing • uric acid