Tempo de sono e marcadores bioquímicos de dislipidemia em crianças com obesidade

Abstract

Sleep duration is a behavioral factor of increasing interest in the literature, as it represents a modifiable risk factor physiologically linked to obesity and the rising prevalence of inadequate sleep duration among the youth. The association between sleep duration and biochemical markers has been investigated; however, results remain inconclusive in the pediatric population. The objective of this study is to examine the association between sleep duration and biochemical markers of dyslipidemia in children with obesity. This is a cross- sectional study utilizing baseline data from a randomized clinical trial for the treatment of childhood obesity - PAPPAS HUPE, which included 101 children aged 7 to 12 years. Sleep duration was calculated based on the question: On average, how many hours do you sleep on a typical night? For descriptive purposes, sleep adequacy was considered between 9-12 hours per day. Biochemical determinations of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides were conducted after a 12-hour fast, utilizing the cut-off points from the Brazilian Guideline on Dyslipidemias and Atherosclerosis Prevention for sample characterization. The association between sleep duration (continuous) and biochemical markers of dyslipidemia was assessed using generalized linear models with identity link, both in unadjusted and adjusted models for gender, age, skin color, and physical activity, stratified by obesity severity (non-severe obesity and severe obesity). All analyses were performed using SAS, version Ondemand. The mean age of the children was a 9.08±1.55 year, with 57.43% being boys. The average daily sleep duration was 8.61±1.58 hours/day. It was observed that 48.5% of participants had inadequate sleep duration, entirely characterized as short sleep, and 47% of children had severe obesity, with a mean BMI z-score of 3.18±0.98. The mean HDL cholesterol (mg/dl) of the children was 45.72±13.39, with 58.7% of the total sample exhibiting altered HDL cholesterol. The mean triglycerides (mg/dl) were 100.39±48.69, and total cholesterol (mg/dl) was 153.91±33.64, with 54% and 23% showing alterations, respectively. The mean LDL cholesterol (mg/dl) was 88.44±25.45, with 17.20% exhibiting alterations. A negative association was observed between sleep duration and LDL cholesterol among children with non-severe obesity, both in the unadjusted model (β = -5.05; p-value=0.01) and the adjusted model (β = -4.11; p-value=0.04). Shorter sleep duration was associated with higher levels of LDL cholesterol in children with non-severe obesity. Understanding that insufficient sleep duration may negatively influence lipid profiles provides a perspective for more effective interventions.