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. 2021 Dec:239:168-174.
doi: 10.1016/j.jpeds.2021.08.031. Epub 2021 Aug 25.

Early Atherosclerotic Inflammatory Pathways in Children with Obstructive Sleep Apnea

David F Smith  1 , Christine L Schuler  2 , Md M Hossain  3 , Guixia Huang  4 , Keith McConnell  5 , Elaine M Urbina  6 , Raouf S Amin  7
Affiliations

Early Atherosclerotic Inflammatory Pathways in Children with Obstructive Sleep Apnea

David F Smith et al. J Pediatr. 2021 Dec.

Abstract

Objective: To evaluate structural and functional carotid changes and inflammatory profiles in children with obstructive sleep apnea (OSA) and healthy controls.

Study design: Patients with OSA and matched controls (ages 5-13 years) were recruited. Proinflammatory cytokines and acute phase reactants were measured at 6:00 p.m. Common carotid artery measures were determined using ultrasound. Confirmatory factor analysis was used to determine subgroups of cytokines and their effects on carotid measures.

Results: Ninety-six patients participated (53 healthy controls, 43 patients with OSA). OSA was associated with increased proinflammatory cytokines (cluster of differentiation-40 ligand [CD40-L], interleukin [IL]-6, and IL-8) and high sensitivity C-reactive protein (P < .05 for all). One cytokine subgroup (IL-6 and IL-8) was negatively associated with markers of carotid function, indicating reduced arterial distensibility and increased stiffness (P < .05 for 3 ultrasound measures); and tumor necrosis factor-α had an opposing effect on carotid function compared with this cytokine subgroup (P < .05 for 2 ultrasound measures). Linear regression demonstrated significant associations between and tumor necrosis factor- α and 2 measures of carotid function (P < .05 for each). Children with OSA did not have functional or structural carotid changes compared with controls.

Conclusion: OSA was not directly associated with structural and functional carotid changes but was associated with upregulation of key proinflammatory cytokines (sCD40-L, IL-6, and IL-8). Together, IL-6 and IL-8 were associated with changes in carotid function. Longitudinal studies are needed to demonstrate that the inflammatory milieu observed in our population is a precursor of atherosclerosis in children.

Keywords: cardiovascular disease; carotid intima media thickness; inflammation; obstructive sleep apnea syndrome; pediatric OSA.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Ren R, Li Y, Zhang J, Zhou J, Sun Y, Tan L, et al. Obstructive sleep apnea with objective daytime sleepiness is associated with hypertension. Hypertension. 2016;68:1264–70. - PubMed
    1. Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005;353:2034–41. - PubMed
    1. Gottlieb DJ, Yenokyan G, Newman AB, O’Connor GT, Punjabi NM, Quan SF, et al. CLINICAL PERSPECTIVE. Circulation. 2010;122:352–60. - PMC - PubMed
    1. Kim J, Mohler ER 3rd, Keenan BT, Maislin D, Arnardottir ES, Gislason T, et al. Carotid Artery Wall Thickness in Obese and Nonobese Adults With Obstructive Sleep Apnea Before and Following Positive Airway Pressure Treatment. Sleep. 2017;40. - PMC - PubMed
    1. Drager LF, Bortolotto LA, Lorenzi MC, Figueiredo AC, Krieger EM, Lorenzi-Filho G. Early signs of atherosclerosis in obstructive sleep apnea. Am J Respir Crit Care Med. 2005;172:613–8. - PubMed

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