Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects

Park, Chan-Soon; Guilleminault, Christian; Hwang, Se Hwan; Jeong, Jong-Hyun; Park, Dong-Sun; Maeng, Jae-Hwan

doi:10.1016/j.sleep.2013.05.012

Cited by 30 publications

(33 citation statements)

References 39 publications

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“…They were conducted in the USA (41–60), Greece (61–65), China (66–68), South Korea (69–71), Italy (72, 73), Brazil (74), and Hungary (75). (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…When the authors used AHI, the AHI ranged from AHI>1 to AHI >5/hrTST. Most of the studies assessed blood biomarkers (41–44, 46, 49–52, 54–57, 59–62, 66–68, 74), while 7 studied urinary biomarkers (47, 48, 53, 58, 63, 64, 73), 4 explored for potential biomarkers in saliva (69–72), and 3 studies involved EBC (45, 65, 75). A summary of the study descriptive characteristics can be found in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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Biomarkers associated with obstructive sleep apnea: A scoping review

Canto

Pachêco‐Pereira

Aydınöz

et al. 2015

Sleep Medicine Reviews

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Summary The overall validity of biomarkers in the diagnosis of obstructive sleep apnea (OSA) remains unclear. We conducted a scoping review to provide assessments of biomarkers characteristics in the context of obstructive sleep apnea (OSA) and to identify gaps in the literature. A scoping review of studies in humans without age restriction that evaluated the potential diagnostic value of biological markers (blood, exhaled breath condensate, salivary, and urinary) in the OSA diagnosis was undertaken. Retained articles were those focused on the identification of biomarkers in subjects with OSA, the latter being confirmed with a full overnight or home-based polysomnography (PSG). Search strategies for six different databases were developed. The methodology of selected studies was classified using an adaptation of the evidence quality criteria from the American Academy of Pediatrics. Additionally the biomarkers were classified according to their potential clinical application. We identified 572 relevant studies, of which 117 met the inclusion criteria. Eighty-two studies were conducted in adults, 34 studies involved children, and one study had a sample composed of both adults and children. Most of the studies evaluated blood biomarkers. Potential diagnostic biomarkers were found in 9 pediatric studies and in 58 adults studies. Only 9 studies that reported sensitivity and specificity, which varied substantially from 43% to 100%, and from 45% to 100%, respectively. Thus, studies in adults have focused on the investigation of IL-6, TNF-α and hsCRP. There was not a specific biomarker that was tested by a majority of authors in pediatric studies, and combinatorial urine biomarker approaches have shown preliminary promising results. In adults IL-6 and IL-10 seem to have a favorable potential to become a good biomarker to identify OSA.

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“…They were conducted in the USA (41–60), Greece (61–65), China (66–68), South Korea (69–71), Italy (72, 73), Brazil (74), and Hungary (75). (Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Biomarkers associated with obstructive sleep apnea: A scoping review

Canto

Pachêco‐Pereira

Aydınöz

et al. 2015

Sleep Medicine Reviews

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“…32 In our previous study, 10 the level of salivary cortisol at night before sleep and in the early morning after waking (two time points) were measured to evaluate the relationships with severity of OSAS, which exhibited that cortisol slope (the ratio of post-to pre-sleep cortisol) might reflect severity of OSAS because there were statistically significant changes (flattened slope) in severe OSAS subgroup, compared to control and mild-to-moderate groups. It would mean that severe OSAS could cause patients not to reach the expected peak level of cortisol.…”

Section: Discussionmentioning

confidence: 99%

“…10 In brief, we prevented enrolled children from eating a major meal for 60 min before collecting the saliva and educated parents for children not to eat or drink dairy products and sugar foods on day of PSG test. Child' mouth was rinsed with water to minimize errors 10 min before saliva sampling.…”

Section: Measurement Of Salivary α-Amylasementioning

confidence: 99%

“…Among them, salivary cortisol may indicate a chronically stressed HPA axis and be a useful biomarker for OSAS. 10 Salivary protein α-amylase (sAA) regulated by the sympathetic nervous system has been suggested as a biomarker for sympathetic activity because sAA activity is a readily accessible, noninvasive parameter that refl ects human responses to physiological and psychological stress. [11][12][13] For example, sAA activity can be used with moderate sensitivity and specifi city to detect acute myocardial infarction in patients with acute chest pain.…”

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confidence: 99%

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Correlation of Salivary Alpha Amylase Level and Adenotonsillar Hypertrophy with Sleep Disordered Breathing in Pediatric Subjects

Park

Guilleminault

Park

et al. 2014

Journal of Clinical Sleep Medicine

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Recently, salivary proteins have gained become of interest in diagnosing a variety of diseases, and several salivary proteins have been suggested as biomarkers to predict a variety of diseases. Among them, salivary cortisol may indicate a chronically stressed HPA axis and be a useful biomarker for OSAS. 10Salivary protein α-amylase (sAA) regulated by the sympathetic nervous system has been suggested as a biomarker for sympathetic activity because sAA activity is a readily accessible, noninvasive parameter that refl ects human responses to physiological and psychological stress. [11][12][13] For example, sAA activity can be used with moderate sensitivity and specifi city to detect acute myocardial infarction in patients with acute chest pain.14 A few studies have been published on α-amylase (AA) related to Study Objectives: Obstructive sleep apnea syndrome (OSAS) and sleep disordered breathing (SDB) can affect the sympathetic adrenomedullary system (SAM). As a biomarker of SAM activity, salivary α-amylase (sAA) in pediatric subjects was evaluated whether it has any correlation with polysomnographic (PSG) parameters related to SDB. Methods: Sixty-seven children who attended our clinic during 1 year were enrolled prospectively and underwent clinical examinations and in-lab polysomnography. The sAA was measured at 2 points-at night before PSG and in the early morning after PSG Results: Subjects were divided into control (n = 26, apneahypopnea index [AHI] < 1) and OSAS (n = 41, AHI ≥ 1) groups. The OSAS group was subdivided according to AHI (mild-moderate, 1 ≤ AHI < 10; severe, AHI ≥ 10). The sAA subtraction and ratio (p = 0.014 and p < 0.001, respectively) were signifi cantly higher in severe OSAS than in the mildmoderate and control groups. Although oxygen desaturation index (ODI) and AHI were signifi cantly associated with sAA, sAA in the OSAS group was not related to lowest oxygen saturation or adenotonsillar hypertrophy. Conclusion: sAA was well related to polysomnographic (PSG) parameters related to SDB, such as AHI and ODI. Therefore, screening test for sAA in children suspected to have SBD may help to identify OSAS patients from control. S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is a relatively common disorder, with an estimated frequency of 2% to 3% in children. Sleep disordered breathing (SDB) has a wide spectrum of respiratory abnormalities from primary snoring to OSA, and its prevalence is estimated to be from 0.9% to 13% in children. Reduced airfl ow (fl ow limitation, hypopnea), increased respiratory effort, and repetitive cessation of airfl ow (apnea) are usually observed in subjects with SDB. As a result, SDB can cause intermittent hypoxia and hypercapnia followed by successive restoration of normo-oxygenation after arousals, which can activate stress responses mediated by the hypothalamic-pituitary-adrenocortical (HPA) axis and the autonomic nervous system (ANS). 2-5It is well known that ANS parasympathetic tone is elevated by apnea and hypopnea, and sympathetic t...

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Serum testosterone/cortisol ratio in people with obstructive sleep apnea

Mohammadi

Rezaei

Sharafkhaneh

et al. 2019

Clinical Laboratory Analysis

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Objectives Obstructive sleep apnea (OSA) is a major health problem that has been associated with endocrine dysfunction in the hypothalamic‐pituitary‐gonadal (HPG) and hypothalamic‐pituitary‐adrenal (HPA) axes. This study investigated cortisol, testosterone, and the testosterone/cortisol ratio in patients with OSA compared to normal sleepers. Methods Thirty‐nine OSA patients diagnosed by overnight polysomnography (PSG) were divided into three groups, including ten mild OSA patients, 16 patients with moderate OSA, and 13 patients with severe OSA according to the apnea‐hypopnea index (AHI). In addition, 13 normal sleepers with normal PSG findings were recruited as the control group. Serum levels of cortisol, testosterone, and sex hormone‐binding globulin (SHBG) were measured using enzyme‐linked immunosorbent assay (ELISA). Results There were no significant differences between the normal sleepers and the three subtypes of OSA in terms of total and free testosterone levels (P > .1). The results showed significantly higher levels of cortisol in the severe OSA group compared to the normal sleepers and the two other subtypes of OSA (P < .01). In addition, the testosterone/cortisol (T/C) ratio was significantly lower among the severe OSA compared to the moderate OSA patients (P = .01). A significant correlation was observed between minimal SpO2 and AHI (r=−0.69, P < .01), cortisol and AHI (r = .47, P < .01) and cortisol and minimal SpO2 (r = −.26, P = .06). Conclusion According to the findings, OSA is linked to HPA axis activity in severe OSA patients but not among the mild and moderate subtypes of the disorder.

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Correlation of salivary cortisol level with obstructive sleep apnea syndrome in pediatric subjects

Cited by 30 publications

References 39 publications

Biomarkers associated with obstructive sleep apnea: A scoping review

Biomarkers associated with obstructive sleep apnea: A scoping review

Correlation of Salivary Alpha Amylase Level and Adenotonsillar Hypertrophy with Sleep Disordered Breathing in Pediatric Subjects

Serum testosterone/cortisol ratio in people with obstructive sleep apnea

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