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Published on: December 6, 2016
C-reactive protein in children with obstructive sleep apnea and the effects of treatment
Albert M Li1, Michael H M Chan, Jane Yin
1Department of Pediatrics, Prince of Wales and Shatin Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. albertmli@cuhk.edu.hk
Insights
Children with obstructive sleep apnea (OSA) have elevated C-reactive protein (CRP) levels, indicating inflammation. Treatment for OSA significantly reduces CRP, suggesting a link between OSA and systemic inflammation.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Biomarkers of Inflammation
Background:
- Obstructive sleep apnea (OSA) is increasingly recognized in children.
- Systemic inflammation is a potential comorbidity of OSA.
- C-reactive protein (CRP) is a marker of inflammation.
Purpose of the Study:
- To measure C-reactive protein (CRP) concentrations in children diagnosed with obstructive sleep apnea (OSA).
- To assess the impact of OSA treatment on serum CRP levels in pediatric patients.
Main Methods:
- Recruitment of children with habitual snoring and OSA symptoms.
- Utilized polysomnography (PSG) for OSA diagnosis (obstructive apnea index > 1).
- Measured fasting serum CRP levels before and after treatment in a subset of patients.
Main Results:
- Children with moderate to severe OSA (OAI > 5) exhibited significantly higher CRP levels compared to non-OSA controls.
- Obstructive apnea index (OAI) was independently associated with CRP levels.
- Treatment for OSA led to a significant reduction in serum CRP levels, with a correlation between CRP and OAI changes.
Conclusions:
- Pediatric OSA is associated with elevated systemic inflammation, as indicated by raised CRP levels.
- Effective treatment of OSA in children can lead to a significant decrease in CRP.
- These findings highlight the inflammatory impact of OSA and the benefits of its treatment.
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 [1.3 (0.8-3.6) vs. 0.7 (0.2-2.0), P=0.01]. Stepwise linear multiple regression analysis indicated that OAI was independently associated with CRP (beta coefficient=0.013, P=0.001). Sixteen children underwent treatment and there was significant reduction in their serum CRP after intervention [pre vs. post-CRP, 1.3 (0.6-4.1) vs. 0.4 (0.2-1.3), P=0.033]. A significant correlation was also demonstrated between change in CRP and change in OAI (r=0.593, P=0.042) following treatment for OSA.
Conclusion:
Children with OSA may have associated systemic inflammation as reflected by a raised CRP that decreased significantly following treatment.
