{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T10:57:49Z","timestamp":1791629869987,"version":"4.3.4"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Obstructive 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 70 Children with obesity and suspected OSA who performed a nocturnal polygraphy to confirm OSA diagnosis and a 3\u2010hour OGTT to assess glucose homeostasis. Mild OSA was defined for 1\u2009&lt;\u2009AHI\u2009\u2264\u20095, moderate\u2013severe OSA as AHI &gt;5. Insulin secretion rate (ISR) was estimated using C\u2010peptide deconvolution. Basal and total insulin clearance during OGTT were calculated. Whole\u2010body 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\u2009minutes of OGTT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 36 children had mild OSA and 34 had moderate\u2013severe OSA. The latter group showed reduced insulin clearance during OGTT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and higher HIRI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Basal insulin clearance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07), ISR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.34), beta\u2010cell glucose sensitivity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.53), and WBISI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.56) were similar between the two groups. OSA severity negatively correlated with fasting insulin clearance (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and OGTT insulin clearance (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) and positively correlated with HIRI (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Moderate\u2013severe OSA in children with obesity is associated with impaired insulin clearance and hepatic insulin sensitivity. These factors may contribute to hyperinsulinism in paediatric OSA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16464","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:40:14Z","timestamp":1747197614000},"page":"4280-4287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Obstructive sleep apnea is associated with impaired insulin clearance and hepatic insulin sensitivity in paediatric obesity"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5570-6620","authenticated-orcid":false,"given":"Giuseppina Rosaria","family":"Umano","sequence":"first","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Aiello","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Rondinelli","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Salvatori","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delfina","family":"Petrone","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Sibillo","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"D'Ausilio","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Marzuillo","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Grandone","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7633-1346","authenticated-orcid":false,"given":"Domenico","family":"Tric\u00f2","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele Miraglia","family":"del Giudice","sequence":"additional","affiliation":[{"name":"Department of the Woman, the Child, and General and Specialized Surgery University of Campania Luigi Vanvitelli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16183235"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2012.5"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-017-1576-4"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-015-2613-6"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27129"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13712"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-004-1513-1"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00385-2015"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2007.05.004"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1530\/JOE-21-0155"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232415462"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8414"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201806-1109TR"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S433514"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.124912"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.94379"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252353"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ22-0280"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/advs.202405955"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.01035"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24065478"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/life14040425"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-023-01257-w"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14076"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.51.10.3014"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2471\/blt.07.043497"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(99)00009-X"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-020-01192-w"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031503"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.41.3.368"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2008.00946.x"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-0750"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-013-2836-x"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-1519"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.2337\/db18-0539"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1983.244.6.E517"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1316"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/antiox12111910"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1242\/jcs.115.6.1273"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng840"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004886"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2023.155607"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15902"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1080\/10409238.2017.1337707"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2021.103208"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmet.2020.101067"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.23679"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01133.2013"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200610-1527OC"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.3389\/frsle.2023.1295301"}],"updated-by":[{"DOI":"10.1111\/dom.71291","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000}}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.16464","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.16464","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.16464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:17:28Z","timestamp":1787591848000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/10.1111\/dom.16464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,14]]},"references-count":50,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/dom.16464"],"URL":"https:\/\/doi.org\/10.1111\/dom.16464","archive":["Portico"],"relation":{},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,14]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}