{"title":"Poor Sleep And Adolescent Obesity Risk: Respiratory Dysfunction [Letter].","authors":"Bruno Bordoni","doi":"10.2147/AHMT.S231168","DOIUrl":null,"url":null,"abstract":"","PeriodicalId":46639,"journal":{"name":"Adolescent Health Medicine and Therapeutics","volume":"10 1","pages":"143-144"},"PeriodicalIF":1.7000,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773973/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Adolescent Health Medicine and Therapeutics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/AHMT.S231168","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
基金会Don Carlo Gnocchi IRCCS，心脏科，住院和护理研究所，科学地址，意大利米兰20100亲爱的编辑，我饶有兴趣地阅读了Duraccio博士的文章和关于肥胖和青春期的评论。所讨论的分析和所报告的思考非常有趣和相关。在寻找肥胖流行的原因时，没有考虑到的一个方面是呼吸膈肌的适应及其系统关系。胸腹区脂肪的积聚导致膈肌收缩力下降，肺弹性降低，呼吸模式改变；儿童和青少年的肥胖会引起不同的呼吸系统问题，从快速疲劳到呼吸困难。膈肌的神经支配与舌突/回缩功能之间存在直接关系。这种连接用于在吸气期间打开高气道；膈肌的功能/结构改变导致舌运动功能障碍和睡眠呼吸暂停的存在。呼吸系统疾病，如阻塞性睡眠呼吸暂停综合征的亚临床表现（打鼾和非持续性呼吸暂停事件），会导致睡眠质量下降和肥胖。我们知道呼吸系统无力与肥胖之间存在关系，特别是富含脂肪的饮食会刺激膈内纤维成脂祖细胞的合成，增加脂肪细胞和I型胶原纤维。这种适应产生了一个恶性循环，其中血小板反应蛋白1（脂肪细胞因子）维持膈肌的负适应。在睡眠呼吸暂停障碍（临床和亚临床）患者中，内脂蛋白-1（下丘脑的神经肽）减少，这与体重增加和食欲增加有关。代谢框架的改变，如青少年肥胖，会产生持续的氧化应激状态，导致胰岛素抵抗/高血糖（以及进一步的肥胖）和呼吸功能下降（收缩功能减弱、肌钙蛋白T耗竭）。膈肌的功能改变导致情绪范围和对外部刺激（外感受）的自我意识（内感受）的改变。膈肌、膈神经/迷走神经支配、孤立核和边缘球之间的传入/传出通路，通讯：Bruno Bordoni基金会Don Carlo Gnocchi IRCCS，心脏科，住院和护理研究所，科学地址：S Maria Nascente，Via Capeceatro 66，Milan 20100，Italy电话+39 02 3496300617电子邮件bordonibruno@hotmail.com青少年健康、医学和治疗Dovepress开放科学和医学研究
期刊介绍：
Adolescent Health, Medicine and Therapeutics is an international, peer reviewed, open access journal focusing on health, pathology, and treatment issues specific to the adolescent age group, including health issues affecting young people with cancer. Original research, reports, editorials, reviews, commentaries and adolescent-focused clinical trial design are welcomed. All aspects of health maintenance, preventative measures, disease treatment interventions, studies investigating the poor outcomes for some treatments in this group of patients, and the challenges when transitioning from adolescent to adult care are addressed within the journal. Practitioners from all disciplines are invited to submit their work as well as health care researchers and patient support groups. Areas covered include: Physical and mental development in the adolescent period, Behavioral issues, Pathologies and treatment interventions specific to this age group, Prevalence and incidence studies, Diet and nutrition, Specific drug handling, efficacy, and safety issues, Drug development programs, Outcome studies, patient satisfaction, compliance, and adherence, Patient and health education programs and studies.
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