However, adults with obstructive sleep apnea (OSA) have both high SNSA and high leptin levels, suggesting possible “leptin resistance.”14 In 1 study, the diagnosis of OSA in adults, independent of obesity, was associated with a ninefold increase in insulin resistance, type 2 diabetes mellitus, hypertension, and/or dyslipidemia, all components of the metabolic syndrome.15 Whether a similar association is seen in obese children is unclear. This evidence concerns the gene LEP and type 2 diabetes mellitus.