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Published on: December 6, 2016
Plasma adhesion molecules in children with sleep-disordered breathing
Louise M O'Brien1, Laura D Serpero, Riva Tauman
1Kosair Children's Hospital Research Institute, University of Louisville School of Medicine, 571 S. Preston St, Suite 321, Louisville, KY 40202, USA.
Insights
Childhood sleep-disordered breathing (SDB) is linked to higher P-selectin levels, indicating inflammation and potential cardiovascular risk. Intercellular adhesion molecule-1 (ICAM-1) elevations were mainly associated with obesity, not SDB.
Area of Science:
- Pediatric Sleep Medicine
- Cardiovascular Health
- Inflammation Markers
Background:
- Childhood sleep-disordered breathing (SDB) is increasingly recognized for its potential long-term health consequences.
- Adhesion molecules are implicated in inflammatory processes and cardiovascular disease.
- Understanding the link between SDB and inflammation markers in children is crucial for early intervention.
Purpose of the Study:
- To investigate the association between childhood sleep-disordered breathing (SDB) and plasma levels of specific adhesion molecules.
- To determine if SDB contributes to inflammatory processes in children.
- To explore the relationship between SDB, obesity, and cardiovascular risk markers.
Main Methods:
- A prospective, observational study was conducted involving 128 children.
- Participants were categorized into SDB, mild SDB, and healthy control groups based on polysomnography.
- Plasma levels of C-reactive protein (CRP), intercellular adhesion molecule-1 (ICAM-1), and P-selectin were measured.
Main Results:
- Children with SDB and mild SDB showed significantly higher plasma P-selectin levels compared to controls.
- P-selectin levels positively correlated with apnea-hypopnea index (AHI), respiratory arousal index, and negatively with oxygen saturation.
- Elevated ICAM-1 levels were primarily associated with obesity, not the severity of SDB.
Conclusions:
- Childhood SDB is associated with elevated plasma P-selectin, suggesting platelet activation and inflammation.
- These findings support the role of SDB in eliciting inflammatory processes in children, potentially increasing cardiovascular morbidity risk.
- ICAM-1 elevations appear more strongly linked to obesity than to SDB in this pediatric cohort.
Study Objectives:
To determine whether childhood sleep-disordered breathing (SDB) is associated with elevated levels of plasma adhesion molecules.
Design:
Prospective, observational study.
Setting:
Sleep Medicine Center of Kosair Children's Hospital.
Participants:
Thirty-nine children with SDB (apnea-hypopnea index [AHI] > 5/h), 47 children with mild SDB (AHI 1 to 5/h), and 42 healthy control subjects (AHI < 1/h).
Measurements And Results:
One hundred twenty-eight children underwent a standard polysomnographic assessment with a blood draw the following morning. Plasma levels of CRP and the adhesion molecules intercellular adhesion molecule (ICAM)-1 and P-selectin were measured. No differences were observed in ICAM-1 levels among the groups; however, obese children had higher ICAM-1 levels than nonobese children (425.0 +/- 123.0 ng/mL vs 375.6 +/- 107.1 ng/mL, p = 0.04) [mean +/- SD]. P-selectin levels were significantly higher in the SDB group (84.0 +/- 52.2 ng/mL) and the mild SDB group (89.3 +/- 49.9 ng/mL) when compared to control subjects (49.5 +/- 22.3 ng/mL; p < 0.001 for both groups). Furthermore, P-selectin correlated with AHI (r = 0.32, p < 0.001), respiratory arousal index (r = 0.27, p = 0.002), and nadir of oxygen saturation as measured by pulse oximetry (r = - 0.19, p = 0.038). Plasma CRP levels were found to correlate with P-selectin even after controlling for BMI (r = 0.20, p = 0.05). No correlations were found between CRP and ICAM-1.
Conclusions:
Children with SDB have plasma elevations of P-selectin, a marker of platelet activation, lending support to the premise that inflammatory processes are elicited by SDB in children, and may contribute to accelerated risk for cardiovascular morbidity. In contrast, elevations in ICAM-1 are primarily associated with obesity rather than SDB.
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