Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep Apnoea
<b>Background</b><b>/Objectives</b>: Childhood obesity represents a growing public health concern. It is closely associated with obstructive sleep apnoea (OSA), which impairs nocturnal breathing and significantly affects neurocognitive and cardiovascular health. This review a...
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MDPI AG
2025-07-01
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| author | Marco Zaffanello Angelo Pietrobelli Giorgio Piacentini Thomas Zoller Luana Nosetti Alessandra Guzzo Franco Antoniazzi |
| author_facet | Marco Zaffanello Angelo Pietrobelli Giorgio Piacentini Thomas Zoller Luana Nosetti Alessandra Guzzo Franco Antoniazzi |
| author_sort | Marco Zaffanello |
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| description | <b>Background</b><b>/Objectives</b>: Childhood obesity represents a growing public health concern. It is closely associated with obstructive sleep apnoea (OSA), which impairs nocturnal breathing and significantly affects neurocognitive and cardiovascular health. This review aims to analyse differences in fat distribution, anthropometric parameters, and instrumental assessments of paediatric OSA compared to adult OSA to improve the diagnostic characterisation of obese children. <b>Methods</b>: narrative review. <b>Results</b>: While adenotonsillar hypertrophy (ATH) remains a primary cause of paediatric OSA, the increasing prevalence of obesity has introduced distinct pathophysiological mechanisms, including fat accumulation around the pharynx, reduced respiratory muscle tone, and systemic inflammation. Children exhibit different fat distribution patterns compared to adults, with a greater proportion of subcutaneous fat relative to visceral fat. Nevertheless, cervical and abdominal adiposity are crucial in increasing upper airway collapsibility. Recent evidence highlights the predictive value of anthropometric and body composition indicators such as neck circumference (NC), neck-to-height ratio (NHR), neck-to-waist ratio (NWR), fat-to-muscle ratio (FMR), and the neck-to-abdominal-fat percentage ratio (NAF%). In addition, ultrasound assessment of lateral pharyngeal wall (LPW) thickness and abdominal fat distribution provides clinically relevant information regarding anatomical contributions to OSA severity. Among imaging modalities, dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and air displacement plethysmography (ADP) have proven valuable tools for evaluating body fat distribution. <b>Conclusions</b>: Despite advances in the topic, a validated predictive model that integrates these parameters is still lacking in clinical practice. Polysomnography (PSG) remains the gold standard for diagnosis; however, its limited accessibility underscores the need for complementary tools to prioritise the identification of children at high risk. A multimodal approach integrating clinical, anthropometric, and imaging data could support the early identification and personalised management of paediatric OSA in obesity. |
| format | Article |
| id | doaj-art-654dbfb34fa44bc8945d9c62bfcb84c0 |
| institution | DOAJ |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj-art-654dbfb34fa44bc8945d9c62bfcb84c02025-08-20T02:45:54ZengMDPI AGChildren2227-90672025-07-0112791210.3390/children12070912Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep ApnoeaMarco Zaffanello0Angelo Pietrobelli1Giorgio Piacentini2Thomas Zoller3Luana Nosetti4Alessandra Guzzo5Franco Antoniazzi6Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, ItalyDepartment of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, ItalyDepartment of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, ItalyDepartment of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, ItalyDepartment of Medicine and Technological Innovation, Insubria University, F del Ponte Hospital, 21100 Varese, ItalyLaboratory Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, ItalyDepartment of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37129 Verona, Italy<b>Background</b><b>/Objectives</b>: Childhood obesity represents a growing public health concern. It is closely associated with obstructive sleep apnoea (OSA), which impairs nocturnal breathing and significantly affects neurocognitive and cardiovascular health. This review aims to analyse differences in fat distribution, anthropometric parameters, and instrumental assessments of paediatric OSA compared to adult OSA to improve the diagnostic characterisation of obese children. <b>Methods</b>: narrative review. <b>Results</b>: While adenotonsillar hypertrophy (ATH) remains a primary cause of paediatric OSA, the increasing prevalence of obesity has introduced distinct pathophysiological mechanisms, including fat accumulation around the pharynx, reduced respiratory muscle tone, and systemic inflammation. Children exhibit different fat distribution patterns compared to adults, with a greater proportion of subcutaneous fat relative to visceral fat. Nevertheless, cervical and abdominal adiposity are crucial in increasing upper airway collapsibility. Recent evidence highlights the predictive value of anthropometric and body composition indicators such as neck circumference (NC), neck-to-height ratio (NHR), neck-to-waist ratio (NWR), fat-to-muscle ratio (FMR), and the neck-to-abdominal-fat percentage ratio (NAF%). In addition, ultrasound assessment of lateral pharyngeal wall (LPW) thickness and abdominal fat distribution provides clinically relevant information regarding anatomical contributions to OSA severity. Among imaging modalities, dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and air displacement plethysmography (ADP) have proven valuable tools for evaluating body fat distribution. <b>Conclusions</b>: Despite advances in the topic, a validated predictive model that integrates these parameters is still lacking in clinical practice. Polysomnography (PSG) remains the gold standard for diagnosis; however, its limited accessibility underscores the need for complementary tools to prioritise the identification of children at high risk. A multimodal approach integrating clinical, anthropometric, and imaging data could support the early identification and personalised management of paediatric OSA in obesity.https://www.mdpi.com/2227-9067/12/7/912anthropometric measurebody compositionchildrenfat distributionobesityobstructive sleep apnoea |
| spellingShingle | Marco Zaffanello Angelo Pietrobelli Giorgio Piacentini Thomas Zoller Luana Nosetti Alessandra Guzzo Franco Antoniazzi Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep Apnoea Children anthropometric measure body composition children fat distribution obesity obstructive sleep apnoea |
| title | Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep Apnoea |
| title_full | Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep Apnoea |
| title_fullStr | Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep Apnoea |
| title_full_unstemmed | Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep Apnoea |
| title_short | Mapping the Fat: How Childhood Obesity and Body Composition Shape Obstructive Sleep Apnoea |
| title_sort | mapping the fat how childhood obesity and body composition shape obstructive sleep apnoea |
| topic | anthropometric measure body composition children fat distribution obesity obstructive sleep apnoea |
| url | https://www.mdpi.com/2227-9067/12/7/912 |
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