ArticleAmerican journal of physiology. Endocrinology and metabolism2016
Inflammation mediates the association between visceral adiposity and obstructive sleep apnea in adolescents.
Article in American journal of physiology. Endocrinology and metabolism, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Normal polysomnography parameters in healthy children: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2026Pooled it
- Causal analysis between altered levels of interleukins and obstructive sleep apnea.Frontiers in immunology · 2022Pooled it
- The Association Between Serum/Plasma Leptin Levels and Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression.Frontiers in endocrinology · 2021Pooled it
- Dynamics in Pro-Inflammatory Cytokines in Response to Hypoglossal Nerve Stimulation in Obstructive Sleep Apnea.Laryngoscope investigative otolaryngology · 2026Article
- The influence of obesity on the risk and severity of obstructive sleep apnea in referred prepubescent children.European journal of pediatrics · 2026Observational
- Association between age-adjusted visceral adiposity index and obstructive sleep apnea: a study based on NHANES 2015-2018.Journal of thoracic disease · 2025Article
- Obstructive Sleep Apnea and Type 2 Diabetes: An Update.Journal of clinical medicine · 2025Review
- Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep Apnoea.Children (Basel, Switzerland) · 2025Review
- C-reactive protein improves the ability to detect hypertension and insulin resistance in mild-to-moderate obstructive sleep apnea: Age effect.Journal of sleep research · 2025Article
- High Body Roundness Index Is Associated With Unhealthy Sleep Patterns: Insights From NHANES (2007-2014).Brain and behavior · 2025Article
- The benefits of hypoglycemic therapy for patients with obstructive sleep apnea.Sleep & breathing = Schlaf & Atmung · 2024Review
- Association of Tumor Necrosis Factor-Alpha, Interleukin-1β, Interleukin-8, and Interferon-γ with Obstructive Sleep Apnea in Both Children and Adults: A Meta-Analysis of 102 Articles.Journal of clinical medicine · 2024Review
- Distinguishing the impact of distinct obstructive sleep apnea syndrome (OSAS) and obesity related factors on human monocyte subsets.Scientific reports · 2024Article
- Exploring the Shared Genetic Architecture Between Obstructive Sleep Apnea and Body Mass Index.Nature and science of sleep · 2024Article
- Edward O. Bixler, PhD: from the Apollo project and chimpanzees to sleep epidemiology.Sleep advances : a journal of the Sleep Research Society · 2024Article
- Sleep disturbance, but not depression severity, is associated with inflammation in children and adolescents.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
- Circadian Misalignment Impacts the Association of Visceral Adiposity With Elevated Blood Pressure in Adolescents.Hypertension (Dallas, Tex. : 1979) · 2023Article
- Potential Pathophysiological Pathways in the Complex Relationships between OSA and Cancer.Cancers · 2023Review
- The causal relationships between obstructive sleep apnea and elevated CRP and TNF-α protein levels.Annals of medicine · 2022Article
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing.Journal of pediatric endocrinology & metabolism : JPEM · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
Only a handful of studies, primarily in clinical samples, have reported an association between obesity, inflammation, and obstructive sleep apnea (OSA) in children and adolescents. No studies, however, have examined the pathogenetic link between visceral adiposity, systemic inflammation, and incident OSA in a large general population sample using objective measures of sleep and body fat. Adolescents (n = 392; mean age 17.0 ± 2.2 yr, 54.0% male) from the Penn State Child Cohort (PSCC) underwent 9-h overnight polysomnography; a DXA scan to assess body fat distribution; and a single fasting blood draw for the assessment of plasma interleukin-6 (IL-6), IL-6 soluble receptor (IL-6 sR), tumor necrosis factor alpha (TNFα), tumor necrosis factor receptor 1A (TNFR1), C-reactive protein (CRP), leptin, and adiponectin levels via ELISA. Visceral fat area was significantly elevated in moderate OSA (AHI ≥ 5), especially in boys. IL-6, CRP, and leptin were highest in adolescents with moderate OSA, even after adjusting for BMI percentile. Mediation analysis revealed that 42% of the association between visceral fat and OSA in adolescents was mediated by IL-6 (p = 0.03), while 82% of the association was mediated by CRP (p = 0.01). These data are consistent with the model of a feed-forward, vicious cycle, in which the release of proinflammatory cytokines by visceral adipocytes largely explains the association between central obesity and OSA; in turn, inflammation is also elevated in OSA independent of BMI. These findings, in a large, representative, non-clinical sample of young people, add to our understanding of the developmental pathogenesis of sleep apnea.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.