The association between insulin resistance, sleep disorders, and inflammation in obese children

Dilek Konuksever 1 * , Sevinç Püren Yücel Karakaya 2
More Detail
1 Department of Pediatrics, Ankara City Hospital, Turkish Ministry of Health, Bilkent, Ankara, Turkey
2 Department of Biostatistics, Cukurova University, Adana, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 3, pp. 82-87. https://doi.org/10.23950/jcmk/13327
OPEN ACCESS 848 Views 734 Downloads
Download Full Text (PDF)

ABSTRACT

Aim: Both obesity and sleep disorders cause chronic subclinical inflammation. Inflammation is a significant factor in triggering insulin resistance. This study aimed to analyze the association between sleep disorders, inflammation, and insulin resistance in obese/overweight children.
Material and methods: In this cross‑sectional study, 150 overweight/obese children were included. Sleep disorder was measured by using the Sleep Disturbance Scale for Children. The homeostasis model of assessment for insulin resistance (HOMA‑IR) was calculated according to fasting glucose and insulin results. Logistic regression models and Spearman Rank Correlation Coefficients were used to estimate associations between parameters.
Results: A statistically significant raising was found in insulin resistance and C-reactive protein levels in those with sleep disorders (p<0.05). However, no correlation was found between sleep disorders and the HOMA-IR, C-reactive protein, and neutrophil-to-lymphocyte ratio levels. On the other hand, HOMA-IR was weak positively correlated with neutrophil-to-lymphocyte ratio (r=0.222, p=0.006), and CRP (r=0.390, p<0.001).
Conclusion: Although we did not detect the association between sleep disorders and insulin resistance and C-reactive protein levels, we revealed that children with sleep disorders had higher insulin resistance and C-reactive protein levels than those without.
Keywords: Sleep, insulin resistance, children, obesity, neutrophil-lymphocyte ratio, C-reactive protein

CITATION

Konuksever D, Yücel Karakaya SP. The association between insulin resistance, sleep disorders, and inflammation in obese children. J CLIN MED KAZ. 2023;20(3):82-7. https://doi.org/10.23950/jcmk/13327

REFERENCES

  • Amin MN, Hussain MS, Sarwar MS, Moghal MMR, Das A, Hossain MZ, Chowdhury JA, Millat MS, Islam MS: How the association between obesity and inflammation may lead to insulin resistance and cancer. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019; 13:1213-1224. https://doi.org/10.1016/j.dsx.2019.01.041
  • Siriwat R, Wang L, Shah V, Mehra R, Ibrahim S: Obstructive sleep apnea and insulin resistance in children with obesity. J Clin Sleep Med. 2020; 16:1081-1090. https://doi.org/10.5664/jcsm.8414
  • Koren D, Taveras EM: Association of sleep disturbances with obesity, insulin resistance and the metabolic syndrome. Metabolism. 2018; 84:67-75. https://doi.org/10.1016/j.metabol.2018.04.001
  • Maugeri A, Medina-Inojosa JR, Kunzova S, Agodi A, Barchitta M, Sochor O, Lopez-Jimenez F, Geda YE, Vinciguerra M: Sleep duration and excessive daytime sleepiness are associated with obesity independent of diet and physical activity. Nutrients. 2018; 10:1219. https://doi.org/10.3390/nu10091219
  • Chehal PK, Shafer L, Cunningham SA: Examination of Sleep and Obesity in Children and Adolescents in the United States. American Journal of Health Promotion. 2022; 36:46-54. https://doi.org/10.1177/08901171211029189
  • Rodrigues GD, Fiorelli EM, Furlan L, Montano N, Tobaldini E: Obesity and sleep disturbances: The "chicken or the egg" question. European Journal of Internal Medicine. 2021; 92:11-16. https://doi.org/10.1016/j.ejim.2021.04.017
  • Deng X, He M, He D, Zhu Y, Zhang Z, Niu W: Sleep duration and obesity in children and adolescents: evidence from an updated and dose-response meta-analysis. Sleep medicine. 2021; 78:169-181. https://doi.org/10.1016/j.sleep.2020.12.027
  • Al-Mansoori L, Al-Jaber H, Prince MS, Elrayess MA: Role of inflammatory cytokines, growth factors and adipokines in adipogenesis and insulin resistance. Inflammation. 2021; 1-14. https://doi.org/10.1007/s10753-021-01559-z
  • Karczewski J, Śledzińska E, Baturo A, Jończyk I, Maleszko A, Samborski P, Begier-Krasińska B, Dobrowolska A: Obesity and inflammation. European cytokine network. 2018; 29:83-94. https://doi.org/10.1684/ecn.2018.0415
  • Irwin MR: Sleep and inflammation: partners in sickness and in health. Nature Reviews Immunology. 2019; 19:702-715. https://doi.org/10.1038/s41577-019-0190-z
  • Muscogiuri G, Barrea L, Annunziata G, Di Somma C, Laudisio D, Colao A, Savastano S: Obesity and sleep disturbance: the chicken or the egg? Critical reviews in food science and nutrition. 2019; 59:2158-2165. https://doi.org/10.1080/10408398.2018.1506979
  • Lee YH: Association between the neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio and rheumatoid arthritis and their correlations with the disease activity: a meta-analysis. Journal of Rheumatic Diseases. 2018; 25:169-178. https://doi.org/10.4078/jrd.2018.25.3.169
  • Apperley LJ, Blackburn J, Erlandson‐Parry K, Gait L, Laing P, Senniappan S: Childhood obesity: A review of current and future management options. Clinical Endocrinology. 2022; 96:288-301. https://doi.org/10.1111/cen.14625
  • Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, Giannotti F: The Sleep Disturbance Scale for Children (SDSC) Construct ion and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. Journal of sleep research. 1996; 5:251-261. https://doi.org/10.1111/j.1365-2869.1996.00251.x
  • Agadayi E, Çelik N, Baser DA: Cocuklar Icin Uyku Bozuklugu Olceginin Turkce Gecerlik ve Guvenirlik Calismasi/Turkish Validity and Reliability of the Sleep Disturbance Scale for Children. Journal of Turkish Sleep Medicine. 2020; 7:65-73.
  • Koren D, Gozal D, Philby MF, Bhattacharjee R, Kheirandish-Gozal L: Impact of obstructive sleep apnoea on insulin resistance in nonobese and obese children. European Respiratory Journal. 2016; 47:1152-1161. https://doi.org/10.1183/13993003.01430-2015
  • Kheirandish-Gozal L, Gozal D: Obstructive sleep apnea and inflammation: proof of concept based on two illustrative cytokines. International journal of molecular sciences. 2019; 20:459. https://doi.org/10.3390/ijms20030459
  • Oyama J-i, Nagatomo D, Yoshioka G, Yamasaki A, Kodama K, Sato M, Komoda H, Nishikido T, Shiraki A, Node K: The relationship between neutrophil to lymphocyte ratio, endothelial function, and severity in patients with obstructive sleep apnea. Journal of cardiology. 2016; 67:295-302. https://doi.org/10.1016/j.jjcc.2015.06.005
  • Zorlu D, Ozyurt S, Bırcan H, Erturk A: Do complete blood count parameters predict diagnosis and disease severity in obstructive sleep apnea syndrome? European Review for Medical and Pharmacological Sciences. 2021; 25:4027-4036.
  • Adamstein NH, Cornel JH, Davidson M, Libby P, de Remigis A, Jensen C, Ekström K, Ridker PM: Association of Interleukin 6 Inhibition With Ziltivekimab and the Neutrophil-Lymphocyte Ratio: A Secondary Analysis of the RESCUE Clinical Trial. JAMA cardiology. 2022. https://doi.org/10.1001/jamacardio.2022.4277
  • Mauss D, Herr RM, Jarczok MN, Motoc I, Fischer JE, Bosch JA: The association of cortisol levels with leukocyte distribution is disrupted in the metabolic syndrome. Obesity Research & Clinical Practice. 2021, 15:78-84. https://doi.org/10.1016/j.orcp.2020.12.003
  • Rodríguez-Rodríguez E, López-Sobaler AM, Ortega RM, Delgado-Losada ML, López-Parra AM, Aparicio A: Association between neutrophil-to-lymphocyte ratio with abdominal obesity and healthy eating index in a representative older Spanish population. Nutrients. 2020; 12:855. https://doi.org/10.3390/nu12030855
  • Karakaya S, Altay M, Efe FK, Karadağ İ, Ünsal O, Bulur O, Eser M, Ertuğrul DT: The neutrophil-lymphocyte ratio and its relationship with insulin resistance in obesity. Turkish Journal of Medical Sciences. 2019; 49:245-248. https://doi.org/10.3906/sag-1804-68
  • Rawat A, Gangwar AK, Tiwari S, Kant S, Garg RK, Singh PK: Sleep quality and insulin resistance in adolescent subjects with different circadian preference: A cross-sectional study. Journal of family medicine and primary care. 2019; 8:2502. https://doi.org/10.4103/jfmpc.jfmpc_400_19
  • Chen P, Baylin A, Lee J, Dunietz GL, Cantoral A, Rojo MMT, Peterson KE, Jansen EC: The association between sleep duration and sleep timing and insulin resistance among adolescents in Mexico City. Journal of Adolescent Health. 2021; 69:57-63. https://doi.org/10.1016/j.jadohealth.2020.10.012
  • Thumann BF, Michels N, Felső R, Hunsberger M, Kaprio J, Moreno LA, Siani A, Tornaritis M, Veidebaum T, De Henauw S: Associations between sleep duration and insulin resistance in European children and adolescents considering the mediating role of abdominal obesity. PloS one. 2020; 15:e0235049. https://doi.org/10.1371/journal.pone.0235049
  • Shaw ND, McHill AW, Schiavon M, Kangarloo T, Mankowski PW, Cobelli C, Klerman EB, Hall JE: Effect of slow wave sleep disruption on metabolic parameters in adolescents. Sleep. 2016; 39:1591-1599. https://doi.org/10.5665/sleep.6028
  • Navarro-Solera M, Carrasco-Luna J, Pin-Arboledas G, González-Carrascosa R, Soriano JM, Codoñer-Franch P: Short sleep duration is related to emerging cardiovascular risk factors in obese children. Journal of pediatric gastroenterology and nutrition. 2015; 61:571-576. https://doi.org/10.1097/MPG.0000000000000868
  • Mansyur MA, Bakri S, Patellongi IJ, Rahman IA: The association between metabolic syndrome components, low-grade systemic inflammation and insulin resistance in non-diabetic Indonesian adolescent male. Clinical nutrition ESPEN. 2020; 35:69-74. https://doi.org/10.1016/j.clnesp.2019.12.001