Inflammatory measures in children with obstructive sleep apnoea

Tam, Charmaine S.; Wong, Melanie; McBain, Rachel A.; Bailey, Sherryn; Waters, Karen A.

doi:10.1111/j.1440-1754.2006.00854.x

Cited by 113 publications

(83 citation statements)

References 44 publications

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“…In addition, the levels of CRP returned to non-OSA range after treatment for OSA independent of any significant change in body weight. Another recent study failed to demonstrate significant relationship between OSA and CRP had a study population very similar to that of Kaditis et al 19 The mean age of the subjects was 7.3 years.…”

Section: Discussionmentioning

confidence: 88%

“…15 There is accumulating evidence to suggest cardiovascular morbidity also exists in childhood OSA, 2,17 but the few studies on CRP in children with OSA have yielded conflicting results. [18][19][20][21] In a study of 81 children with a mean age of 9.3 years, Tauman et al 20 demonstrated a significant correlation between CRP and the apnea hypopnea index (AHI). Similar correlation between CRP and sleep apnea severity was also documented in a study involving older children with a mean age of 13.7 years.…”

Section: Introductionmentioning

confidence: 99%

“…18 However, these positive results were not confirmed by two recent studies. 19,21 Adipose tissue is an important source of inflammatory cytokines which are essential inducers for CRP production. 22 Obesity is therefore a confounding factor in the correlation between CRP and OSA and that can partly explain discrepancies between results of published studies.…”

Section: Introductionmentioning

confidence: 99%

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C‐reactive protein in children with obstructive sleep apnea and the effects of treatment

Chan

Yin

et al. 2007

Pediatric Pulmonology

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Summary. Objective To evaluate C-reactive protein (CRP) concentration in children with OSA and to determine the effects of treatment for OSA on its serum concentration. Methods Consecutive children with habitual snoring and symptoms suggestive of OSA were recruited. They completed a sleep apnea symptom questionnaire, underwent physical examination and an overnight polysomnography (PSG). Fasting serum CRP and lipid profile were taken after overnight PSG. OSA was diagnosed if obstructive apnea index (OAI) > 1. Results One hundred forty-one children with a median (IQR) age of 10.8 (8.5-12.8) years were recruited. There were 96 boys and the commonest presenting symptoms were nocturnal mouth breathing, prone sleeping position and poor attention at school. Forty-five children were found to have OSA and those with moderate disease (OAI > 5) had significantly higher CRP levels compared to their non-OSA counterparts

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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C‐reactive protein in children with obstructive sleep apnea and the effects of treatment

Chan

Yin

et al. 2007

Pediatric Pulmonology

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“…P-selectin, C-reactive protein, fibrinogen, interleukin-8, and interferon-␥ levels were found to be higher in children with snoring and/or OSA compared with control subjects. [387][388][389][390][391] In a study of 143 adolescents, mean C-reactive protein level demonstrated a dose-response increase with SDB that was independent of BMI and partially explained by the severity of nocturnal hypoxemia. 91 Whether these mediators predict cardiovascular risk in children and adolescents has yet to be demonstrated.…”

Section: Endothelial Dysfunctionmentioning

confidence: 99%

Sleep Apnea and Cardiovascular Disease

et al. 2008

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“…8 Other well-studied mechanisms related to obstructive sleep apnea-hypopnea involve endothelial dysfunction and hypoxiarelated expression of proinflammatory cytokines. [12][13][14] A combination of inflammation and vasoconstrictive stimuli largely accounts for the high blood pressure in these patients and for the difficulty to optimally control their values. 15 In the morbid obese population in the study by Avelar et al, 4 body mass index and nocturnal saturation of O 2 account for most of the explained variance of LV mass in addition to systolic blood pressure measured at the office visit.…”

mentioning

confidence: 99%

Morbid Obesity and Left Ventricular Geometry

Simone

2007

Hypertension

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O besity is a condition encompassing a broad range of clinical presentations from a nearly normal status to a life-threatening disease. In the absence of a permeating campaign raising the level of attention to the problem of obesity, many obese individuals see their doctors only for esthetic reasons. A large number of subjects, in fact, seem to live quite well even with moderate or severe obesity. Others, albeit feeling healthy, look for dietary interventions not only to improve their body build but also to increase the level of their self-esteem. Some others, a minority, usually those in class III, 1 progressively develop symptoms and clinical signs that raise their level of attention and force them to see doctors.The latter type of obese subjects is usually more motivated and, therefore, tends to be more compliant with physicians' suggestions and indications. There is a proportion of these individuals who are considered to be at higher risk, and when their motivations are strong enough, they are sent to bariatric surgery. When examining those obese subjects, doctors and researchers need to be aware that they represent the tip of the iceberg, far away from the reality of obesity in general and from the real cardiovascular risk attributable to obesity in population. Because of the a priori selection, hypertension, diabetes, joint pain, and whatever comorbidity is limiting quality of life are very frequent in those patients. Their cardiovascular risk is higher than in obese patients without prevalent comorbidities, and, unsurprisingly, they also show high levels of left ventricular (LV) mass partly related to coexisting abnormalities consistent with findings in the setting of the metabolic syndrome. 2,3 Abnormalities of LV geometry get worse as the severity of morbid obesity increases.In this issue of the journal, Avelar et al 4 add another important observation by focusing their study on the effect of obstructive sleep apnea-hypopnea on levels of LV mass in obese patients with some compelling indications for bariatric surgery. The vast majority of these patients were women. Although the authors used a method of normalization of LV mass that minimizes the gender difference, there is, however, gender difference in the distribution of obstructive sleep apnea-hypopnea episodes and, most likely, in their severity, as also confirmed in recent works. 5,6 Although the effort of breathing is not necessarily different in men and women when lying the same, the physiology of breathing is different in men and women even in the presence of similar obstructive conditions, particularly when excessive abdominal fat compresses the diaphragm toward the chest.Even considering the potential gender-related limitations, the observation by Avelar et al 4 that the degree of sustained nocturnal hypoxemia, rather than the number of apneic and hypopneic episodes, contributes to the variance of LV mass index is interesting, because it indicates a real measurable biological characteristic potentially associated with LV mass. Focusing on hypo...

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Inflammatory measures in children with obstructive sleep apnoea

Cited by 113 publications

References 44 publications

C‐reactive protein in children with obstructive sleep apnea and the effects of treatment

C‐reactive protein in children with obstructive sleep apnea and the effects of treatment

Sleep Apnea and Cardiovascular Disease

Morbid Obesity and Left Ventricular Geometry

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