The Indian Journal of Pediatrics

, Volume 86, Supplement 1, pp 15–19 | Cite as

Identifying Pathways Mediating Obstructive Sleep Apnea and Obesity in Indian Children

  • Giulia Lorenzoni
  • Danila Azzolina
  • Gulshan Sethi
  • Sanjay Manchanda
  • Dario Gregori
  • Achal Gulati
  • Ileana BaldiEmail author
Original Article



Overweight and obesity in children is associated with several metabolic and cardiovascular impairments, including obstructive sleep apnea (OSA). However, the causal pathway from OSA to obesity is not fully known yet. The aim of this study was to explore the association between OSA and obesity-related metabolic outcomes in obese Indian children.


An observational, cross-sectional study was conducted. Obese children referred to the Otorhinolaryngology Department at the Maulana Azad Medical College (New Delhi, India) for suspicion of OSA were consecutively enrolled. OSA was diagnosed by polysomnographic parameters. Homeostasis model assessment (HOMA) was calculated to measure insulin sensitivity and HOMA > 4.39 was considered as a threshold for insulin resistance. The association between various polysomnographic measures and HOMA, adiponectin and various urinary catecholamines was assessed.


Complete polysomnographic parameters were available for 45 children; of these 29 were found to suffer from OSA. OSA children had significantly higher glucose concentrations compared to non-OSA ones (p value = 0.012) but no differences were found in insulin resistance and urinary catecholamines levels. Older age was significantly associated to lower levels of catecholamines. No significant associations were found between polysomnographic parameters and both HOMA and adiponectin. Only age was found to be significantly associated with HOMA (p = 0.03) and adiponectin (p = 0.01).


A better understanding of the role played by OSA on obese children’s metabolic functions is crucial to implement specific prevention strategies to reduce the public health burden of non-communicable diseases.


Obese children OSA Insulin resistance Catecholamines India 



IB, AG, DG: Designed the study; IB, GL: Wrote the manuscript; DG, DA: Performed the statistical analysis; SM, GS: Critically revised the manuscript and contributed to the discussion. All authors contributed to results interpretation, read and approved the final manuscript. IB will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding

This work is partially supported by an unrestricted grant within the Executive Programme of Scientific and Technological Cooperation between the Italian Republic and the Republic of India, agreed by Ministry of Foreign Affairs, Directorate General for the Country Promotion (Economy, Culture and Science) of the Republic of Italy and the Ministry of Science & Technology, Department of Science and Technology, of the Republic of India, and from Prochild ONLUS (Italy).


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Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  • Giulia Lorenzoni
    • 1
  • Danila Azzolina
    • 1
  • Gulshan Sethi
    • 2
  • Sanjay Manchanda
    • 3
  • Dario Gregori
    • 1
  • Achal Gulati
    • 4
  • Ileana Baldi
    • 1
    Email author
  1. 1.Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly
  2. 2.Department of PediatricsMaulana Azad Medical CollegeNew DelhiIndia
  3. 3.Department of Sleep MedicineSir Ganga Ram HospitalNew DelhiIndia
  4. 4.Department of Otorhinolaryngology and Head and Neck SurgeryMaulana Azad Medical College and Associated Lok Nayak HospitalNew DelhiIndia

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