OSA risk in middle age linked to early childhood, adulthood BMI, weight gain

Key takeaways:

• Researchers found a significant link between high OSA risk and conditional weight and BMI gains during early childhood and adulthood age ranges.
• Conditional height had no link to middle age OSA risk.

BOSTON — Adults who experienced BMI or weight gains between age 2 years and 5 years, as well as after age 11 years, faced increased odds for high obstructive sleep apnea risk, according to data presented at the CHEST Annual Meeting.

“This study adds OSA to the list of noncommunicable diseases associated with excessive weight gain in early life,” Tejas Suri, MBBS, MD, DM, assistant professor at All India Institute of Medical Sciences in New Delhi, told Healio.

“Recent international consensus guidelines for small gestational age babies have advised against excessive weight gain in early childhood to prevent the occurrence of subsequent cardiometabolic disease,” Suri said. “Our study reaffirms this growing call for implementing lifestyle interventions, including dietary measures and exercise, starting in early childhood to prevent excess weight gain.”

Using data from the New Delhi Birth Cohort study, Suri and colleagues assessed 521 adults (mean age, 40.9 years; 58.9% men) to identify how postnatal growth in conditional BMI, weight and height during four age ranges — infancy (0 to 2 years), early childhood (2 to 5 years), late childhood (5 to 11 years) and adulthood (11 years to adult age) — each impact OSA risk odds in middle age.

“Over the past few decades, it has become established that excessive gain in weight in relation to height during early childhood can predispose to various noncommunicable diseases in adulthood, including obesity, diabetes mellitus, hypertension, stroke and coronary heart disease,” Suri told Healio. “OSA in adulthood is associated with all of these diseases, but its risk has not been extensively studied in the context of childhood growth.”

When analyzed at birth, the males in this study population weighed an average of 2.87 kg, whereas the females weighed 2.8 kg, according to the abstract.

Prior to turning 11 years old, researchers found mean BMIs under standards defined by WHO.

A greater proportion of women vs. men had obesity in adulthood (40.7% vs. 21.8%), but more men than women had a high risk for OSA (33.2% vs. 27.6%), which was classified by researchers as fulfillment of two or three domains on the Berlin Questionnaire.

In terms of BMI, the age- and sex-adjusted odds for high OSA risk in adulthood significantly rose if individuals had greater conditional BMI during three of the four age ranges: early childhood (adjusted OR = 1.39; 95% CI, 1.1-1.77), late childhood (aOR = 1.31; 95% CI, 1.04-1.65) and adulthood (aOR = 2.69; 95% CI, 2.04-3.53).

Additionally, researchers found a significant link between high OSA risk and conditional weight gains during early childhood (aOR = 1.38; 95% CI, 1.09-1.75). A similar outcome was found when considering conditional weight gains during adulthood (aOR = 2.42; 95% CI, 1.86-3.15).

In contrast, conditional height had no link to middle age OSA risk, according to the abstract.

“Our study, unique in its focus on a middle-class urban cohort in Delhi, India, with over 4 decades of follow-up, revealed a significant association,” Suri told Healio. “Despite our cohort’s relatively low average birth weight and childhood weights compared to Western populations, we found that excessive weight gain in early childhood was linked to the subsequent risk of OSA in middle age.”

Looking ahead, Suri said more research outside of the assessed urban, middle-class study cohort is necessary.

“The findings of our study are valid for urban middle-class populations in developing countries globally,” Suri told Healio. “However, we need more studies from various socioeconomic and geographical settings worldwide to understand better the relationship between early life growth and the development of OSA in adulthood.

“Further, while our study used a questionnaire to assess the risk of OSA, future studies will use newer technologies, including wearable devices, to determine the risk of obstructive sleep apnea in community settings,” Suri continued.