阻塞性睡眠呼吸暂停低通气综合征对肥胖儿童智力发育水平影响的研究进展

王夏燕; 凌继祖; 叶新华; 蔡甘露

doi:10.11852/zgetbjzz2024-0616

PDF(612 KB)

中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (2) : 203-207. DOI: 10.11852/zgetbjzz2024-0616

综述

阻塞性睡眠呼吸暂停低通气综合征对肥胖儿童智力发育水平影响的研究进展

王夏燕¹, 凌继祖², 叶新华³, 蔡甘露⁴

作者信息 +

Impact of obstructive sleep apnea hypopnea syndrome on intellectual development in obese children

WANG Xiayan¹, LING Jizu², YE Xinhua³, CAI Ganlu⁴

Author information +

文章历史 +

摘要

儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)发病率高,对其生长发育、行为问题和神经认知功能等方面产生负面影响。肥胖可单独存在影响智力发展,也使OSAHS发病的风险上升,伴随着儿童肥胖率的逐年提高,肥胖儿童OSAHS产生认知功能障碍的研究在近年成为热点,本综述将对肥胖儿童OSAHS的智力发育相关的研究进展进行梳理。

Abstract

Obstructive sleep apnea hypopnea syndrome (OSAHS) has a high incidence rate in children and negatively impacts their growth and development,behavior, and neurocognitive functions. Obesity can independently impact intellectual development and also increases the risk of OSAHS. With the annual rise in childhood obesity rates, research on cognitive dysfunction in obese children with OSAHS has become a hot topic in recent years. This review will summarize the advances in studies related to intellectual development in obese children with OSAHS.

导出引用

王夏燕, 凌继祖, 叶新华, 蔡甘露. 阻塞性睡眠呼吸暂停低通气综合征对肥胖儿童智力发育水平影响的研究进展[J]. 中国儿童保健杂志. 2025, 33(2): 203-207 https://doi.org/10.11852/zgetbjzz2024-0616

WANG Xiayan, LING Jizu, YE Xinhua, CAI Ganlu. Impact of obstructive sleep apnea hypopnea syndrome on intellectual development in obese children[J]. Chinese Journal of Child Health Care. 2025, 33(2): 203-207 https://doi.org/10.11852/zgetbjzz2024-0616

中图分类号： R725.6 R729

参考文献

[1] Uwiera TC. Considerations in surgical management of pediatric obstructive sleep apnea: Tonsillectomy and beyond[J]. Children (Basel), 2021, 8(11):944.
[2] 中国居民营养与慢性病状况报告(2020年)[J].营养学报,2020,42(6):521.
Report on the status of nutrition and chronic diseases in China (2020)[J]. Chinese Journal of Nutrition, 2020, 42(6): 521.(in Chinese)
[3] Tim L, Rachel JL, Powis J. World obesity atlas 2023[Z]. World Obesity Federation,World Obesity Atlas, 2023.
[4] Tanaka H, Gourley DD, Dekhtyar M, et al. Cognition, brain structure, and brain function in individuals with obesity and related disorders[J]. Curr Obes Rep, 2020, 9(4): 544-549.
[5] Costa DJ, Mitchell R. Adenotonsillectomy for obstructive sleep apnea in obese children: A meta-analysis[J]. Otolaryngol Head Neck Surg, 2009, 140(4): 455-460.
[6] Marcus CL, Curtis S, Koerner CB, et al. Evaluation of pulmonary function and polysomnography in obese children and adolescents[J]. Pediatr Pulmonol, 1996, 21(3): 176-183.
[7] Samoilova YG, Matveeva MV, Spirina LV, et al. Neuroinflammation in obese children[J]. Bull Exp Biol Med, 2024, 176(3): 386-389.
[8] Sui SX, Pasco JA. Obesity and brain function: The brain-body crosstalk[J]. Medicina (Kaunas), 2020, 56(10):499.
[9] Ou X, Andres A, Pivik R T, et al. Brain gray and white matter differences in healthy normal weight and obese children[J]. J Magn Reson Imaging, 2015, 42(5): 1205-1213.
[10] Shao XY, Tan LH, He LF. Physical activity and exercise alter cognitive abilities, and brain structure and activity in obese children[J]. Front Neurosci, 2022, 16:1019129.
[11] Poh BK, Lee ST, Yeo GS, et al. Low socioeconomic status and severe obesity are linked to poor cognitive performance in Malaysian children[J]. BMC Public Health, 2019, 19(Suppl 4): 541.
[12] Jiang FK, Li GY, Ji WB, et al. Obesity is associated with decreased gray matter volume in children: A longitudinal study[J]. Cereb Cortex, 2023, 33(7): 3674-3682.
[13] Jin Y, Wu RZ, Li L, et al. Exosomes from inflamed macrophages promote the progression of parkinson′s disease by inducing neuroinflammation[J]. Mol Neurobiol, 2023, 60(4): 1914-1928.
[14] Marti-NIicolovius M. Effects of overweight and obesity on cognitive functions of children and adolescents[J]. Rev Neurol, 2022, 75(3): 59-65.
[15] Rosen ED, Spiegelman BM. What we talk about when we talk about fat[J]. Cell, 2014, 156(1-2): 20-44.
[16] Cheng G, Deng YX, Zhou ZP, et al. Neuroprotective effect of leptin on a primate model of cerebral ischemia[J]. Anim Biotechnol, 2022, 33(7): 1591-1601.
[17] Menzies B, Teng A, Burns M, et al. Neurocognitive outcomes of children with sleep disordered breathing: A systematic review with meta-analysis[J]. Sleep Med Rev, 2022, 63: 101629.
[18] Ji TT, Ren XM, Long T, et al. Aberrant topological properties of brain functional network in children with obstructive sleep apnea derived from resting-state fMRI[J]. Brain Topogr, 2023, 36(1): 72-86.
[19] Shi YW, Feng YN, Zhang YT, et al. Assessment of event-related evoked potentials and China-Wechsler intelligence scale for cognitive dysfunction in children with obstructive sleep apnea[J]. Int J Pediatr Otorhinolaryngol, 2021, 150: 110901.
[20] Zhao J, Han SJ, Zhang JS, et al. Association between mild or moderate obstructive sleep apnea-hypopnea syndrome and cognitive dysfunction in children[J]. Sleep Med, 2018, 50: 132-136.
[21] Cui JQ, Li GY, Zhang MM, et al. Associations between body mass index, sleep-disordered breathing, brain structure, and behavior in healthy children[J]. Cereb Cortex, 2023, 33(18): 10087-10097.
[22] Eldin MS, Alahmer M, Alkashlan E, et al. Alterations in inflammatory markers and cognitive ability after treatment of pediatric obstructive sleep apnea[J]. Medicina (Kaunas), 2023, 59(2):204.
[23] Vitelli O, Tabarrini A, Miano S, et al. Impact of obesity on cognitive outcome in children with sleep-disordered breathing[J]. Sleep Med, 2015, 16(5): 625-630.
[24] Xu JM, Wang XJ, Qian C, et al. Exploration of the association between obesity and cognitive impairment in chinese children with mild or moderate obstructive sleep apnea-hypopnea syndrome[J]. J Pediatr Nurs, 2020, 53: 36-40.
[25] Coimbra-costa D, Alva N, Duran M, et al. Oxidative stress and apoptosis after acute respiratory hypoxia and reoxygenation in rat brain[J]. Redox Biol, 2017, 12: 216-225.
[26] 耿雅轩,王宇清.儿童阻塞性睡眠呼吸暂停低通气综合征认知功能损害的研究进展[J].国际儿科学杂志,2021,48(4):249-252.
Geng YX, Wang YQ. Research progress on cognitive impairment in children with obstructive sleep apnea-hypopnea syndrome[J]. Int J Pediatr, 2021, 48(4): 249-252.(in Chinese)
[27] Coimbra-Costa D, Alva N, Duran M, et al. oxidative stress and apoptosis after acute respiratory hypoxia and reoxygenation in rat brain[J]. Redox Biol, 2017,12:216-225.
[28] Feng YN, Ma LN, Chen X, et al. Relationship between serum brain-derived neurotrophic factor and cognitive impairment in children with sleep-disordered breathing[J]. Front Pediatr, 2022, 10:1027894.
[29] Li W, Yu Y, Li D, et al. TLR2 deficiency attenuated chronic intermittent hypoxia-induced neurocognitive deficits[J]. Int Immunopharmacol, 2020, 81:106284.
[30] Lee MH, Sin S, Lee S, et al. Cortical thickness and hippocampal volume in adolescent children with obstructive sleep apnea[J]. Sleep, 2023, 46(3): zsac201.
[31] Polsek D, Bago M, ZˇivalJjic M, et al. A novel adjustable automated system for inducing chronic intermittent hypoxia in mice[J]. PLoS One, 2017, 12(3): e0174896.
[32] Owen JE, Benediktsdottir B, Gislason T, et al. Neuropathological investigation of cell layer thickness and myelination in the hippocampus of people with obstructive sleep apnea[J]. Sleep, 2019, 42(1):10.
[33] Shi YW, Feng YN, Chen X, et al. Serum neurofilament light reflects cognitive dysfunctions in children with obstructive sleep apnea[J]. BMC Pediatr, 2022, 22(1): 449.
[34] Gao XL, Wu SJ, Dong YT, et al. Role of the endogenous cannabinoid receptor 1 in brain injury induced by chronic intermittent hypoxia in rats[J]. Int J Neurosci, 2018, 128(9): 797-804.
[35] 刘志明,额尔敦高娃,张继华,等.阻塞性睡眠呼吸暂停低通气综合征对儿童智力发育影响的观察[J].河北医药,2012,34(4): 513-514.
Liu ZM, Erdun Gaowa, Zhang JH, et al. Effect of obstructive sleep apnea-hypopnea syndrome on children′s mental development[J]. Hebei Medicine, 2012, 34(4): 513-514.(in Chinese)
[36] Lenehan SM, Fogarty L, O′connor C, et al. The architecture of early childhood sleep over the first two years[J]. Matern Child Health J, 2023, 27(2): 226-250.
[37] Waters KA, Chawla J, Harris MA, et al. Cognition after early tonsillectomy for mild OSA[J]. Pediatrics, 2020, 145(2): e20191450.
[38] 逯国奎.阻塞性睡眠呼吸暂停低通气综合征儿童术后认知功能的恢复情况[J].临床医药文献电子杂志, 2016, 3(53): 10540-10541.
Lu GK. Recovery of postoperative cognitive function in children with obstructive sleep apnea-hypopnea syndrome[J]. Electronic Journal of Clinical Medical Literature, 2016,3(53):10540-10541.(in Chinese)
[39] Patel A, Chong DJ. Obstructive sleep apnea: Cognitive outcomes[J].Clin Geriatr Med, 2021,37(3):457-467.
[40] 史方海,陈忠仁.CPAP对阻塞性睡眠呼吸暂停低通气综合征患者认知功能及AHI、LSaO2的影响[J].中华肺部疾病杂志(电子版),2022,15(4):539-541.
Shi FH,Chen ZR. Effect of CPAP on cognitive function and AHI and LSaO2 in patients with obstructive sleep apnea-hypopnea syndrome[J].Chinese Journal of Lung Diseases(Electronic Edition),2022,15(4):539-541.(in Chinese)
[41] Cohen-Gogo S, Do NT, Levy D, et al. Les troubles respiratoires du sommeil chez l′enfant Sleep-disordered breathing in children[J].Arch Pediatr, 2009,16(2):123-131.
[42] Liu XM, Ma YM,Ouyang RY, et al. The relationship between inflammation and neurocognitive dysfunction in obstructive sleep apnea syndrome[J]. J Neuroinflammation, 2020, 17(1): 229.
[43] Yu Y, Chen YX, Liu L, et al. Neuropsychological functioning after adenotonsillectomy in children with obstructive sleep apnea: A meta-analysis[J]. J Huazhong Univ Sci Technolog Med Sci, 2017, 37(3): 453-461.
[44] Marcus CL, Brooks LJ,Draper KA,et,al. Diagnosis and management of childhood obstructive sleep apnea syndrome[J].Pediatrics, 2012, 130(3):e714-e755.
[45] 喻玲,邸宝春,包立华,等.有氧运动综合干预对肥胖儿童伴阻塞性睡眠呼吸暂停低通气综合征认知功能的影响[J].中国煤炭工业医学杂志,2022,25(1):62-67.
Yu L,Di BC, Bao LH, et al. Effect of comprehensive aerobic exercise intervention on cognitive function in obese children with obstructive sleep apnea-hypopnea syndrome[J]. China Journal of Coal Industry Medicine, 2022, 25(1): 62-67.(in Chinese)
[46] Eldin MAS, Alahmer M, Alkashlan E, et al. Alterations in inflammatory markers and cognitive ability after treatment of pediatric obstructive sleep apnea[J/OL]. Medicina, 2023, 59(2): 204.