Impact of obstructive sleep apnea on metabolic markers in non-obese children living at high altitudes: A cross-sectional study

Background Obstructive sleep apnea (OSA) has been associated with cardiometabolic disturbances in obese children at sea level. However, it remains unclear whether this relationship is independent of obesity, or what the effect of hypoxia at high altitudes is. Methods To assess the relationship between OSA and metabolic markers (glucose, insulin, triglycerides, cholesterol, and complete blood count) in children living at high altitudes (2640 m above sea level), we conducted a cross-sectional analytical study using quantile regression models to control for confounding variables. Results A total of 309 patients aged 5 to 16 years were included (54.7% male, 6.5% obese, and 68.9% with OSA). Severe OSA was associated with higher triglyceride levels (coefficient: 17.43; 95% CI: 3.699—31.16; p = 0.013) and a trend toward higher systolic blood pressure (Median percentile: 50.5) compared to patients without OSA (Median percentile: 39.5; p = 0.058). A trend toward higher insulin resistance was observed with higher desaturation indices (coefficient: 0.016; 95% CI: −0.0002—0.033; p = 0.053). A trend toward higher triglyceride levels was also found with higher O-AHI (coefficient: 0.645; 95% CI: −0.088—1.379; p = 0.085). No associations were found with diastolic blood pressure, cholesterol, hemoglobin, or glucose levels. Conclusions We found a weak association between OSA and triglyceride levels, insulin resistance, and systolic blood pressure. Considering that less than 7% of our population was obese, these findings suggest an association independent of obesity between OSA and metabolic disturbances in residents at high altitudes.