Evidence map›Paper›PMID 40365648›Full record

ArticleDiabetes, obesity & metabolism2025

Obstructive sleep apnea is associated with impaired insulin clearance and hepatic insulin sensitivity in paediatric obesity.

Giuseppina Rosaria Umano, Francesca Aiello, Giulia Rondinelli, Alessandra Salvatori, Delfina Petrone, Maria Vittoria Sibillo, Raffaella D'Ausilio, Pierluigi Marzuillo, Anna Grandone, Grazia Cirillo and 2 more

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Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Giuseppina Rosaria UmanoDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.ORCID 0000-0002-5570-6620
Francesca AielloDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Giulia RondinelliDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Alessandra SalvatoriDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Delfina PetroneDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Maria Vittoria SibilloDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Raffaella D'AusilioDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Pierluigi MarzuilloDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Anna GrandoneDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Grazia CirilloDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Domenico TricòDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.ORCID 0000-0002-7633-1346
Emanuele Miraglia Del GiudiceDepartment of the Woman, the Child, and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsObstructive sleep apnea (OSA) affects up to 40% of children and adolescents with obesity and is linked to hyperinsulinism. However, the mechanisms underpinning this association remain unclear. The study aims to assess the three key determinants of hyperinsulinemia: insulin clearance, secretion, and sensitivity in paediatric patients with OSA.

methodsWe enrolled 70 Children with obesity and suspected OSA who performed a nocturnal polygraphy to confirm OSA diagnosis and a 3-hour OGTT to assess glucose homeostasis. Mild OSA was defined for 1 < AHI ≤ 5, moderate-severe OSA as AHI >5. Insulin secretion rate (ISR) was estimated using C-peptide deconvolution. Basal and total insulin clearance during OGTT were calculated. Whole-body insulin sensitivity was evaluated with the Matsuda Index (WBISI), while hepatic insulin resistance index (HIRI) was calculated based on the AUCs of plasma glucose and insulin during the initial 30 minutes of OGTT.

resultsA total of 36 children had mild OSA and 34 had moderate-severe OSA. The latter group showed reduced insulin clearance during OGTT (p = 0.008) and higher HIRI (p = 0.03). Basal insulin clearance (p = 0.07), ISR (p = 0.34), beta-cell glucose sensitivity (p = 0.53), and WBISI (p = 0.56) were similar between the two groups. OSA severity negatively correlated with fasting insulin clearance (r = -0.29, p = 0.01) and OGTT insulin clearance (r = -0.32, p = 0.007) and positively correlated with HIRI (r = 0.29, p = 0.02).

conclusionModerate-severe OSA in children with obesity is associated with impaired insulin clearance and hepatic insulin sensitivity. These factors may contribute to hyperinsulinism in paediatric OSA.

Indexed as

HyperinsulinismInsulinInsulin ResistanceLiverPediatric ObesitySleep Apnea, ObstructiveAdolescentBlood GlucoseChildFemaleGlucose Tolerance TestHumansInsulin SecretionMaleBlood GlucoseInsulininsulin clearanceobesityobstructive sleep apnea

Identifiers

PMID40365648
PMCPMC12232289

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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.