Inflammatory Markers and Obstructive Sleep Apnea in Obese Children: The NANOS Study

Abstract EN

Introduction.

Obesity and obstructive sleep apnea syndrome (OSA) are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities.

Aim.

To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG) variables.

Methods.

In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4–15 years) were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw.

Plasma samples were assayed for multiple inflammatory markers.

Results.

204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI) of 3 events/hour total sleep time (TST).

BMI, gender, and age were similar in OSA and no-OSA children.

Monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST; P < 0.01 ) , while MCP-1 levels were associated with more prolonged nocturnal hypercapnia ( P < 0.001 ) .

Conclusion.

IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA.

This trial is registered with ClinicalTrials.gov NCT01322763.