Effects of adenotonsillectomy on plasma inflammatory biomarkers in obese children with obstructive sleep apnea: A community-based study.
Effects of adenotonsillectomy on plasma inflammatory biomarkers in obese children with obstructive sleep apnea: A community-based study.
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DOI：
10.1038/ijo.2015.37
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发表时间：
2015-07
影响因子：
4.9
通讯作者：
Gozal, D.
中科院分区：
文献类型：
--
作者：
Kheirandish-Gozal, L.;Gileles-Hillel, A.;Alonso-Alvarez, M. L.;Peris, E.;Bhattacharjee, R.;Teran-Santos, J.;Duran-Cantolla, J.;Gozal, D.
肥胖和阻塞性睡眠呼吸暂停综合征(OSA)是儿童中非常普遍且经常重叠的疾病，导致全身炎症，后者与与这些疾病相关的各种终末器官疾病有关。目的观察腺扁桃体切除术(T&A)对多导睡眠图确诊为阻塞性睡眠呼吸暂停综合征(OSA)的肥胖儿童血浆炎性标志物水平的影响。预期诊断为阻塞性睡眠呼吸暂停综合征的肥胖儿童在手术后接受T&A和第二次通宵多导睡眠图(PSG)检查。空腹采血检测血浆中多种炎症和代谢指标，包括白介素6(IL-6)、白介素18(IL-18)、纤溶酶原激活物抑制物-1(PAI-1)、单核细胞趋化蛋白-1(MCP-1)、基质金属蛋白酶-9(MMP9)、脂联素、载脂蛋白C、瘦素和骨分泌素。在122名潜在的候选人中，100名患有阻塞性睡眠呼吸暂停综合征的肥胖儿童完成了这项研究，只有三分之一的儿童在T&A后表现出他们的PSG正常化(即AHI≤1/hrTST)。然而，总体上，单核细胞趋化蛋白-1、纤溶酶原激活物抑制物-1、基质金属蛋白酶-9、IL-18和IL-6在并购后显著降低，而肾上腺素和骨分泌素血浆浓度升高。一些并购反应生物标志物对预测残存阻塞性睡眠呼吸暂停低通气综合征表现出极好的敏感性和中等的特异性(即呼吸暂停低密度脂蛋白≥/hrTST)。在社区肥胖儿童OSA的背景下，定义的全身性炎症和代谢生物标志物的子集被可逆地改变，进一步强化了OSA和肥胖等睡眠障碍导致下游终末器官疾病的交互促炎效应的概念。
Obesity and obstructive sleep apnea syndrome (OSA) are highly prevalent and frequently overlapping conditions in children that lead to systemic inflammation, the latter being implicated in the various end-organ morbidities associated with these conditions. To examine the effects of adenotonsillectomy (T&A) on plasma levels of inflammatory markers in obese children with polysomnographically diagnosed OSA who were prospectively recruited from the community. Obese children prospectively diagnosed with OSA, underwent T&A and a second overnight polysomnogram (PSG) after surgery. Plasma fasting morning samples obtained after each of the 2 PSG were assayed for multiple inflammatory and metabolic markers including interleukin-6 (IL-6), IL-18, plasminogen activator inhibitor-1 (PAI-1), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase- (MMP-9), adiponectin, apelin C, leptin and osteocrin. Out of 122 potential candidates, 100 obese children with OSA completed the study with only 1/3 exhibiting normalization of their PSG after T&A (i.e., AHI≤1/hrTST). However, overall significant decreases in MCP-1, PAI-1, MMP-9, IL-18 and IL-6, and increases in adropin and osteocrin plasma concentrations occurred after T&A. Several of the T&A responsive biomarkers exhibited excellent sensitivity and moderate specificity to predict residual OSA (i.e., AHI≥/hrTST). A defined subset of systemic inflammatory and metabolic biomarkers is reversibly altered in the context of OSA among community-based obese children, further reinforcing the concept on the interactive pro-inflammatory effects of sleep disorders such as OSA and obesity contributing to downstream end-organ morbidities.
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DOI：
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发表时间：
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期刊：
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