Our study is the first long-term multi-center prospective cohort study to simultaneously evaluate metabolic and cardiovascular markers in a modest sample of youth with obesity newly prescribed PAP therapy for moderate-severe SDB. We found a high prevalence of cardiometabolic dysfunction in youth newly diagnosed with SDB. More than 40% had evidence of insulin resistance (HOMA-IR > 97th percentile) and hypertension. Most (70%) also had loss of the nocturnal BP dip. As some others have found, we observed a significant association between a marker of inflammation (hs-CRP) and obesity (BMI Z-score) at baseline, but other metabolic and BP markers were not significantly associated with indices of SDB.4 Although there were no statistically significant improvements in cardio metabolic markers 1 year after the prescription of PAP
therapy, clinically relevant improvements were seen in insulin resistance and systolic BP load,
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