Obstructive sleep apnoea syndrome (OSAS) as a risk factor for secondary osteoporosis in children

Sies, Nur Syazwin; Zaini, Azriyanti Anuar; Bruyne, Jessie Anne de; Jalaludin, Muhammad Yazid; Nathan, Anna Marie; Han, Ng Yit; Thavagnanam, Surendran

doi:10.1038/s41598-021-82605-6

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…Deficiency in TrATPase is associated with spondylenchondrodysplasia, a disorder that combines abnormal bone development, various autoimmune diseases and central nervous abnormalities. Interestingly, OSA has been associated with osteoporosis in recent studies [ 21 , 22 , 23 ], a possible reflection of hypoxia.…”

Section: Discussionmentioning

confidence: 99%

Proteomic Biomarkers of the Apnea Hypopnea Index and Obstructive Sleep Apnea: Insights into the Pathophysiology of Presence, Severity, and Treatment Response

Cederberg

Hanif

Sempere

et al. 2022

IJMS

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Obstructive sleep apnea (OSA), a disease associated with excessive sleepiness and increased cardiovascular risk, affects an estimated 1 billion people worldwide. The present study examined proteomic biomarkers indicative of presence, severity, and treatment response in OSA. Participants (n = 1391) of the Stanford Technology Analytics and Genomics in Sleep study had blood collected and completed an overnight polysomnography for scoring the apnea–hypopnea index (AHI). A highly multiplexed aptamer-based array (SomaScan) was used to quantify 5000 proteins in all plasma samples. Two separate intervention-based cohorts with sleep apnea (n = 41) provided samples pre- and post-continuous/positive airway pressure (CPAP/PAP). Multivariate analyses identified 84 proteins (47 positively, 37 negatively) associated with AHI after correction for multiple testing. Of the top 15 features from a machine learning classifier for AHI ≥ 15 vs. AHI < 15 (Area Under the Curve (AUC) = 0.74), 8 were significant markers of both AHI and OSA from multivariate analyses. Exploration of pre- and post-intervention analysis identified 5 of the 84 proteins to be significantly decreased following CPAP/PAP treatment, with pathways involving endothelial function, blood coagulation, and inflammatory response. The present study identified PAI-1, tPA, and sE-Selectin as key biomarkers and suggests that endothelial dysfunction and increased coagulopathy are important consequences of OSA, which may explain the association with cardiovascular disease and stroke.

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Section: Discussionmentioning

confidence: 99%

Proteomic Biomarkers of the Apnea Hypopnea Index and Obstructive Sleep Apnea: Insights into the Pathophysiology of Presence, Severity, and Treatment Response

Cederberg

Hanif

Sempere

et al. 2022

IJMS

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“…Repetitive hypoxia seen in obstructive sleep apnea syndrome (OSAS) may affect bone metabolism, increasing the risk for secondary osteoporosis [45].…”

Section: Obstructive Sleep Apnea and Obstructive Sleep Apnea Syndromementioning

confidence: 99%

Upper Airway Expansion in Disabled Children

Andrade¹,

Andrade²,

Palha³

et al. 2022

Dentistry

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Breathing is essential for life in all of its stages. Cellular, mitochondrial respiration requires an adequate supply of oxygen, provided by the air we breathe, after airway conduction, treatment by the lungs, and transport to tissues. At different stages of life, pediatric dentists and orthodontists can intervene in the upper airway, expanding it, which helps with ventilation. The greater airway space, if used, contributes in different ways to the child’s development and the recovery of respiratory problems and should always be present as a weapon that physicians and the population should know. The value of the techniques becomes even more important when applied to children and young people with disabilities who can significantly improve their development and performance. Rapid Maxillary Expansion and Extraoral Traction Appliances are two important pediatric resources to treat these children. Clinical practice of the authors, is discussed, emphasizing the importance of early intervention and the need for multi and interdisciplinary collaboration in the follow-up of disabled people.

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“…The prevalence of obstructive sleep apnea (OSA), a type of sleep-disordered breathing, is 1% to 4% among children . Early intervention in OSA is crucial to prevent impaired growth, adverse cardiovascular consequences, learning deficits, and poor quality of life …”

Section: Introductionmentioning

confidence: 99%

“…T he prevalence of obstructive sleep apnea (OSA), a type of sleep-disordered breathing, is 1% to 4% among children. [1][2][3] Early intervention in OSA is crucial to prevent impaired growth, 4,5 adverse cardiovascular consequences, [6][7][8][9] learning deficits, 10 and poor quality of life. 11 Upper airway obstruction, often caused by adenoid and/or tonsil hypertrophy, is the most common anatomical cause of pediatric OSA.…”

mentioning

confidence: 99%

Changes in Cone-Beam Computed Tomography Pediatric Airway Measurements After Adenotonsillectomy in Patients With OSA

Liu

Kang

Yao

et al. 2022

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEEarly intervention using cone-beam computed tomography (CBCT) and adenotonsillectomy for children with obstructive sleep apnea (OSA) may prevent impaired growth, adverse cardiovascular consequences, learning deficits, and poor quality of life.OBJECTIVE To assess changes in CBCT airway measurements and polysomnography (PSG) parameters that occur after adenotonsillectomy in children with OSA and to determine whether CBCT changes are correlated with apnea-hypopnea index (AHI) reduction. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study was conducted at a tertiary medical center from 2013 to 2016. Children aged 7 to 13 years with PSG-confirmed OSA (ie, AHI Ն1) were recruited. Data analysis was performed from March to July 2021.EXPOSURES All participants underwent CBCT and PSG before and after adenotonsillectomy. MAIN OUTCOMES AND MEASURESChanges in PSG and CBCT parameters after adenotonsillectomy were analyzed.RESULTS A total of 49 children (mean [SD] age, 9.5 [1.8] years; 34 boys [69.4%]) were recruited. Eighteen participants (36.7%) had obesity. After adenotonsillectomy, AHI significantly decreased from 11.4 to 1.2 events per hour (mean difference, −10.24 events per hour; 95% CI, −13.84 to −6.64 events per hour). The following CBCT parameters significantly increased: total airway volume (from 11 265 to 15 161 mm 3 ; mean difference, 3896.6 mm 3 ; 95% CI, 2788.0 to 5005.2 mm 3 ), nasopharyngeal volume (from 2366 to 3826 mm 3 ; mean difference, 1459.7 mm 3 ; 95% CI, 1122.9 to 1796.5 mm 3 ), minimal nasopharyngeal airway area (from 128 to 191 mm 2 ; mean difference, 63.1 mm 2 ; 95% CI, 47.4 to 78.8 mm 2 ), mean nasopharyngeal airway area (from 144 to 231 mm 2 ; mean difference, 86.8 mm 2 ; 95% CI, 67.0 to 106.5 mm 2 ), oropharyngeal volume (from 8898 to 11 335 mm 3 ; mean difference, 2436.9 mm 3 ; 95% CI, 1477.0 to 3396.8 mm 3 ), minimal oropharyngeal airway area (from 82 to 158 mm 2 ; mean difference, 76.2 mm 2 ; 95% CI, 57.0 to 95.4 mm 2 ), and mean oropharyngeal airway area (from 182 to 234 mm 2 ; mean difference, 52.5 mm 2 ; 95% CI, 33.6 to 71.4 mm 2 ). Among all parameters, only body mass index percentile showed large effect size between the group with residual OSA (postoperative AHI Ն1) and the group with resolved disease, with the residual OSA group having a higher body mass index percentile (87.8 vs 61.4; mean difference, 26.33; 95% CI, 10.00 to 42.66). A quantile regression model revealed that total airway volume and minimal oropharyngeal airway area were significantly correlated with reductions in AHI.CONCLUSIONS AND RELEVANCE These findings suggest that in children undergoing adenotonsillectomy, improvements in total airway volume and oropharyngeal minimal airway area were correlated with reduction of AHI. Future studies are needed to assess whether CBCT has a role in the evaluation of children with OSA who are being considered for adenotonsillectomy.

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Obstructive sleep apnoea syndrome (OSAS) as a risk factor for secondary osteoporosis in children

Cited by 5 publications

References 32 publications

Proteomic Biomarkers of the Apnea Hypopnea Index and Obstructive Sleep Apnea: Insights into the Pathophysiology of Presence, Severity, and Treatment Response

Proteomic Biomarkers of the Apnea Hypopnea Index and Obstructive Sleep Apnea: Insights into the Pathophysiology of Presence, Severity, and Treatment Response

Upper Airway Expansion in Disabled Children

Changes in Cone-Beam Computed Tomography Pediatric Airway Measurements After Adenotonsillectomy in Patients With OSA

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