Systemic inflammation in non-obese children with obstructive sleep apnea

Gozal, David; Serpero, Laura D.; Capdevila, Óscar Sans; Kheirandish‐Gozal, Leila

doi:10.1016/j.sleep.2007.04.013

Cited by 193 publications

(136 citation statements)

References 46 publications

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“…Furthermore, it has been shown that SDB has an independent additive effect on the inflammatory changes caused by overweight and obesity in children and adolescents (6). Results of the inflammatory markers at baseline in this report are consistent with the effects of SDB (8,9). However, the lowering of the hs-CRP levels was not linked to improvements in either sleep or anthropometric parameters.…”

Section: Discussionsupporting

confidence: 86%

“…In examining these results the following statements need to be considered. It is known that both obesity and SDB induce a low-grade systemic inflammatory response (6)(7)(8)(9)22,23). Furthermore, it has been shown that SDB has an independent additive effect on the inflammatory changes caused by overweight and obesity in children and adolescents (6).…”

Section: Discussionmentioning

confidence: 99%

“…As to inflammation, previous studies showed that SDB leads to a low-grade inflammation, as measured among others by leukocyte counts or C-reactive protein (CRP) levels. In addition, there is a resolution of this inflammatory response after treating SDB with adenotonsillectomy, the most common treatment option in the pediatric population (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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Weight Loss and Sleep‐Disordered Breathing in Childhood Obesity: Effects on Inflammation and Uric Acid

Hoorenbeeck

Franckx²,

Debode³

et al. 2012

Obesity

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Sleep‐disordered breathing (SDB) is prevalent in childhood obesity. It may be an independent risk factor for the metabolic syndrome. Possible mechanisms are inflammation and oxidative stress. Adenotonsillectomy in childhood obesity is associated with a high recurrence rate and risk of postoperative weight gain. Therefore, this study assessed the effects of SDB on inflammation and oxidative stress in childhood obesity before and after weight loss. We included 132 obese subjects between 10 and 18 years consecutively. Median age was 15.4 years (10.1–18.0). Mean BMI z‐score was 2.72 ± 0.42. Leukocytes and differentiation, high sensitivity C‐reactive protein (hs‐CRP), and uric acid (UA) were determined at baseline and subjects underwent a sleep assessment. SDB was diagnosed in 39%. Linear regression analysis showed an association between UAlog and oxygen desaturation indexlog (ODIlog) (r = 0.20; P = 0.03), between leukocyteslog and respiratory disturbance indexlog (RDIlog) (r = 0.23; P = 0.01), and between lymphocyteslog and RDIlog (r = 0.19; P = 0.04). Follow‐up was organized after 4–6 months of treatment. Median decrease in BMI z‐score was 32%. Laboratory measurements were repeated. Subjects with SDB at baseline underwent a second sleep study. Of these 49 subjects, 12 showed residual SDB. This corresponds with a treatment success rate of 71%. Unlike changes in inflammatory markers, improvements in UA were associated with improvements in RDI and ODI (respectively: r = 0.44; P = 0.007, r = 0.41; P = 0.01). In conclusion, weight loss is effective in treating obese children with SDB. At baseline, a link exists between inflammation and SDB. Oxidative stress is reflected by UA at baseline and the concentration decreases after treatment according to improvements in SDB.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Weight Loss and Sleep‐Disordered Breathing in Childhood Obesity: Effects on Inflammation and Uric Acid

Hoorenbeeck

Franckx²,

Debode³

et al. 2012

Obesity

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“…Obesity is one of the strongest risk factors for developing OSAS (3,4). Meanwhile, clinical and fundamental studies suggest that inflammation involves the pathogenesis of OSAS (5)(6)(7)26,27) and IL-6 was reported to phenotypically increase in patients with OSAS (28)(29)(30). In an attempt to elucidate the relationship between genetic variants in the IL-6 gene and OSAS, we provided two aspects of support with a population-based study.…”

Section: Discussionmentioning

confidence: 91%

Genetic variants in interleukin-6 modified risk of obstructive sleep apnea syndrome

Zhang

Liu²,

Li³

et al. 2009

Int J Mol Med

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Abstract. Obesity and inflammation are known to correlate with the pathogenesis of obstructive sleep apnea syndrome (OSAS). Interleukin (IL)-6, an important regulator of obesity and inflammation, was reported to phenotypically increase in patients with OSAS. This study aimed to investigate whether genetic variants in IL-6 confer susceptibility to OSAS. The study population consisted of 151 patients with OSAS and 75 healthy controls from Southeast China. Five haplotype-tagging single nucleotide polymorphisms (tSNPs) were selected across 21 kb of the IL-6 locus using Haploview software V4.1. The tSNPs were amplified by polymerase chain reaction (PCR) and genotyped by restriction enzyme digestion followed by gel electrophoresis. Linkage disequilibrium (LD) and haplotype reconstruction were carried out by means of a SHEsis program. No distribution difference of any of the five tSNPs between OSAS patients and controls was observed. However, in nonobese individuals (n=117), the minor allele G (rs1800796) decreased risk of OSAS compared with the major allele C [odds ratio (OR), 0.48; 95% confidence interval (CI), 0.26-0.86; p=0.014], and the haplotype TG (rs1880242, rs1800796) conferred a significantly decreased risk of OSAS than single allele G (rs1800796) (OR, 0.39; 95% CI, p=0.003). Moreover, the severity of sleep-disordered breathing (measured by apnea hypopnea index) increased linearly in carriers of the C variant of IL-6 -572G/C polymorphism (14.3±5.1, 22.0±3.6 and 34.8±3.5 for GG, CG and CC, respectively; p=0.012). To the best of our knowledge, this is the first study to suggest that genetic variants in IL-6 could modify OSAS susceptibility. SNP genotyping of IL-6 is a potential strategy for detecting the risk of breathing disordered diseases in non-obese individuals.

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“…In particular, the activation of inflammatory pathways by OSA has emerged as a possible important contributor to end organ injury associated with this disorder, perhaps especially in the presence of concomitant obesity [46][47][48]. The role of a systemic inflammatory process in OSA is supported by findings of increased C-reactive protein (CRP) and IL-6 levels and lower IL-10 levels in children with OSA, which has been reported to improve following adenotonsillectomy [49][50][51] and one month of nasal CPAP therapy. However, data is mixed regarding CRP improvement after adenotonsillectomy in obese children with OSA [6,52].…”

Section: Sleep Disordered Breathingmentioning

confidence: 99%

Current Treatment of Selected Pediatric Sleep Disorders

Sullivan

2012

Neurotherapeutics

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While pediatric sleep disorders are relatively common, treatments are often not straightforward. There is often a paucity of gold standard studies and data available to guide clinicians, treatments may yield arguably incomplete results, interventions may require chronic use, and/ or involve multiple modalities including behavioral interventions that require high parental and family commitment. This review points out diagnostic differences compared to adults and focuses on current therapy for selected common pediatric sleep disorders including sleep disordered breathing/ obstructive sleep apnea, narcolepsy, and restless legs syndrome. Other common pediatric sleep disorders, such as insomnia and parasomnias, are not covered.

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Systemic inflammation in non-obese children with obstructive sleep apnea

Abstract: Systemic inflammation is a constitutive component and consequence of OSA in many children, even in the absence of obesity, and is reversible upon treatment in most patients.

Cited by 193 publications

References 46 publications

Weight Loss and Sleep‐Disordered Breathing in Childhood Obesity: Effects on Inflammation and Uric Acid

Weight Loss and Sleep‐Disordered Breathing in Childhood Obesity: Effects on Inflammation and Uric Acid

Genetic variants in interleukin-6 modified risk of obstructive sleep apnea syndrome

Current Treatment of Selected Pediatric Sleep Disorders

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