OBSTRUCTIVE SLEEP APNEA SYNDROME IN CHILDREN AS A RISK OF CARDIOVASCULAR PATHOLOGY DEVELOPMENT

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Abstract

Objective: Our aim was to examine the predictors of cardiovascular disorders in children affected by obstructive sleep apnea syndrome (OSAS) based on the results of polysomnography and continuous monitoring of blood glycose. Мethods: Before the examination, parents filled in questionnaires concerning their children sleep quality. The procedure was followed by the study of the sleep by means of polysomnography (Embla s 7000, USA). A system of continuous monitoring of blood glucose was applied (Guardianreal-time, Medtronicminimed, USA) by means of which a glycemic profile tissue fluid was studied. Results: A night sleep research of 120 children aged 3–16 y.o. is presented. There were 4 groups depending on the pathology: diseases of the nervous system (n =31), ENT-pathology (n =18), bronchial asthma (n =24) and overweight and obesity (n =34). The comparison group consisted of 13 apparently healthy children. The study has shown that the parents of every second child with sleep disorders did not know about the fact. The 60 % of the patients with high body mass index (BMI) had a snore, which was significantly higher the in children with normal body mass index — 35% (р =0.012). The index of apnea-hypopnea (AHI) was higher in the patients with ENT-pathology 17 times (p <0.001) and the patients with obesity 7 times (p <0.001) in comparison to the comparison group. In the analysis of the overall sample (n =120) was obtained significant negative correlation with heart rate variability and heart rate (r = 0.405; p <0.001). It is also shown that among 14 investigated children with OSAS only 8 had episodes of hypoglycemia (less than 3.3 mmol/l) during night sleep. All of them were with a high body mass index and with above average stature (>1sd). Conclusion: Children with ENT-pathology and with high high body mass index have high risk of cardio-vascular diseases. Children with above average stature and with increased body mass index affected by OSAS have additional backgrounds for cardiovascular diseases development as a result of the latent periods of hypoglycemia at night.

 

About the authors

O. V. Kozhevnikova

Scientific Centre of Children’s Health, Moscow, Russian Federation

Author for correspondence.
Email: fd@nczd.ru
кандидат медицинских наук, заведующая отделением инструментальной и лабораторной диагностики КДЦ НИИ ППиВЛ Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20u Russian Federation

L. S. Namazova-Baranova

Scientific Centre of Children’s Health, Moscow, Russian Federation
Sechenov First Moscow State Medical University, Russian Federation
Pirogov Russian National Research Medical University, Moscow, Russian Federation

Email: namazova@nczd.ru

профессор, член-корреспондент РАН, заместитель директора —директор НИИ ППиВЛ Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

Russian Federation

E. A. Abashidze

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: 2803abashidze@mail.ru

кандидат медицинских наук, врач отделения инструментальной и лабораторной диагностики Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

Russian Federation

V. V. Altunin

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: altuninv1@gmail.com
кандидат медицинских наук, врач отделения инструментальной и лабораторной диагностики Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20 Russian Federation

A. S. Balabanov

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: a-balabanov@yandex.ru

кандидат социологических наук, научный сотрудник отдела социальной педиатрии Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (965) 314-16-33

Russian Federation

I. V. Shirokova

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: shirokova@nczd.ru

кандидат медицинских наук, врач-эндокринолог клинического отделения Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

Russian Federation

I. I. Kondrakhina

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: fd@nczd.ru
врач-лаборант отделения инструментальной и лабораторной диагностики Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

T. A. Polunina

Scientific Centre of Children’s Health, Moscow, Russian Federation

Email: tapolunina@rambler.ru

кандидат медицинских наук, заведующая ОВЛД с болезнями ЛОР-органов и челюстно-лицевой области Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 134-08-41

Russian Federation

T. V. Margieva

Scientific Centre of Children’s Health, Moscow, Russian Federation
Sechenov First Moscow State Medical University, Russian Federation

Email: pedpharm@nczd.ru

кандидат медицинских наук, заведующая ОВЛД c нефроурологическими заболеваниями, ожирением и метаболическими болезнями Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 132-28-80

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