Early cardiac abnormalities and increased C-reactive protein levels in a cohort of children with sleep disordered breathing

Villa, Maria Pia; Ianniello, Filomena; Evangelisti, Melania; Miano, Silvia; Ferrucci, Andrea; Ciavarella, Giuseppino Massimo; Volpe, Massimo

doi:10.1007/s11325-010-0462-0

Cited by 39 publications

(25 citation statements)

References 36 publications

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“…[424344] However, other authors concluded that CRP, TNF-α, and IL6 levels in patients with OSAHS are elevated, independently of obesity, and are related to increased metabolic and cardiovascular diseases, sleepiness, and fatigue. [45464748] In our study, there is no association between IL-17, VD, and BMI. Hence, it can be hypothesized that OSAHS is associated with VD deficiency and serum levels of IL-17 increase independently of obesity.…”

Section: Discussioncontrasting

confidence: 61%

Vitamin D deficiency and interleukin-17 relationship in severe obstructive sleep apnea–hypopnea syndrome

et al. 2017

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PURPOSE:We aimed to assess Vitamin D (VD) abnormalities in patients with severe obstructive sleep apnea–hypopnea syndrome (OSAHS), to study its association with clinical and polygraphic data, and to correlate VD levels with interleukin-17 (IL-17).METHODS:Ninety-two patients with severe OSAHS were consecutively enrolled between September 2014 and February 2016 and compared to age-, sex-, and body mass index (BMI)-matched controls. Anthropometric parameters and medical history were collected. The serum levels of VD and IL-17 were determined by radioimmunoassay and enzyme-linked immunosorbent assay, respectively.RESULTS:Ninety-two severe OSAHS patients and thirty controls were enrolled in the study. All OSAHS patients had VD deficiency. The mean level of VD was at 7.9 ng/ml among OSAHS group versus 16.8 ng/ml among control group. IL-17A levels were elevated (20.3 pg/ml) in OSAHS group compared to healthy group (10.05 pg/ml). VD levels were negatively correlated with nocturia severity (r = −0.26; P = 0.01) and positively correlated with mean O2 saturation (r = 0.59; P = 0.02) and lowest O2 saturation (r = 0.3; P = 0.03). IL-17 levels were positively correlated with nocturia severity (r = 0.24; P = 0.03) and negatively correlated with mean O2 saturation (r = −0.42; P = 0.03). A significant negative association was observed between IL-7 and VD levels (r = −0.64, P = 0.2 10−4). The magnitude of this correlation was higher for important nocturia, lower MSaO2, or higher BMI.CONCLUSIONS:VD deficiency in patients with severe OSAHS is common with a negative association between IL-17 and VD serum levels. Hypoxia could play an important role in this association. Further studies are needed to clarify this relationship.

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Section: Discussioncontrasting

confidence: 61%

Vitamin D deficiency and interleukin-17 relationship in severe obstructive sleep apnea–hypopnea syndrome

et al. 2017

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“…We used salivary α‐amylase as a marker of ANS activity, and did not find evidence of autonomic dysregulation concomitant with HPA axis activation. However, it can be argued that the OSA children enrolled in this study were free of any of major adverse consequences of OSA . Furthermore, our cohort did not include obese children, were younger than the most children usually enrolled in published studies, and presented with a shorter disease duration .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, our cohort did not include obese children, were younger than the most children usually enrolled in published studies, and presented with a shorter disease duration . It is therefore possible that longer duration or higher severity of the disease are required to activate the HPA axis, which in turn will promote the induction of OSA‐associated ANS perturbations, the latter being linked to BP elevations and decreased nocturnal BP dipping, as well as left ventricular (LV) hypertrophy and early LV diastolic dysfunction …”

Section: Discussionmentioning

confidence: 99%

“…However, it can be argued that the OSA children enrolled in this study were free of any of major adverse consequences of OSA. [50][51][52] Furthermore, our cohort did not include obese children, were younger than the most children usually enrolled in published studies, and presented with a shorter disease duration. 53,54 It is therefore possible that longer duration or higher severity The data are shown as the mean values AE SEM.…”

Section: Discussionmentioning

confidence: 99%

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Salivary biomarkers of obstructive sleep apnea syndrome in children

et al. 2014

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“…A number of pediatric studies have identified potential biomarkers for OSA. These include tumor necrosis factor, C‐reactive protein, plasma adropin, inflammatory mediators including leukotrienes and prostaglandins in exhaled breath condensate, urinary neurotransmitters, and serum proteomic pattern . In 2015, Canto and colleagues performed a systematic review and meta‐analysis to evaluate the potential diagnostic value of biological markers for OSA .…”

Section: Future Osa Assessment Toolsmentioning

confidence: 99%

Preoperative identification of children at high risk of obstructive sleep apnea

Ohn

Eastwood

Ungern‐Sternberg

2020

Pediatric Anesthesia

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Obstructive sleep apnea is a common childhood disorder which can lead to serious health problems if left untreated. Enlarged adenoid and tonsils are the commonest causes, and adenotonsillectomy is the recommended first line of treatment. Obstructive sleep apnea poses as an anesthetic challenge, and it is a well‐known risk factor for perioperative adverse events. The presence and severity of an obstructive sleep apnea diagnosis will influence anesthesia, pain management, and level of monitoring in recovery period. Preoperative obstructive sleep apnea assessment is necessary, and anesthetists are ideally placed to do so. Currently, there is no standardized approach to the best method of preoperative screening for obstructive sleep apnea. Focused history, clinical assessments, and knowledge regarding the strengths and limitations of available obstructive sleep apnea assessment tools will help recognize a child with obstructive sleep apnea in the preoperative setting.

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Early cardiac abnormalities and increased C-reactive protein levels in a cohort of children with sleep disordered breathing

Abstract: This study shows that OSAS in children is associated with higher LV mass, early LV diastolic dysfunction and a pro-inflammatory state (high CRP levels). These findings might help to explain the higher incidence of cardiovascular morbidity in patients with OSAS.

Cited by 39 publications

References 36 publications

Vitamin D deficiency and interleukin-17 relationship in severe obstructive sleep apnea–hypopnea syndrome

Vitamin D deficiency and interleukin-17 relationship in severe obstructive sleep apnea–hypopnea syndrome

Salivary biomarkers of obstructive sleep apnea syndrome in children

Preoperative identification of children at high risk of obstructive sleep apnea

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