Plasma IGF-1 levels and cognitive dysfunction in children with obstructive sleep apnea
David Gozal1, Oscar Sans Capdevila, Valerie McLaughlin Crabtree
1Kosair Children's Hospital Research Institute, and Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville School of Medicine, 570 S. Preston Street, Suite 204, Louisville, KY 40202, USA. david.gozal@louisville.edu
Insights
Higher Insulin-like Growth Factor-1 (IGF-1) levels may protect children with Obstructive Sleep Apnea (OSA) from cognitive deficits. This study suggests IGF-1
Area of Science:
- Pediatric Sleep Medicine
- Neuroendocrinology
- Child Cognitive Development
Background:
- Pediatric Obstructive Sleep Apnea (OSA) is linked to cognitive impairments.
- Cognitive performance varies among children with OSA, regardless of severity.
- Insulin-like Growth Factor-1 (IGF-1) has neuroprotective properties.
Purpose of the Study:
- To investigate the relationship between IGF-1 levels and cognitive function in children with OSA.
- To determine if higher IGF-1 levels are associated with a lower risk of cognitive morbidity in pediatric OSA.
Main Methods:
- Recruited 5-7 year old children (snoring and non-snoring).
- Conducted polysomnography, neurocognitive testing, and blood draws.
- Measured plasma IGF-1 levels via ELISA and categorized children based on OSA and cognitive status.
Main Results:
- Children with OSA had higher IGF-1 levels than those without OSA (1070 vs. 910 pg/mL).
- Children with OSA and cognitive deficits had significantly lower IGF-1 levels (540 pg/mL) compared to those with OSA and normal cognition (1370 pg/mL).
Conclusions:
- Elevated IGF-1 levels are observed in children with OSA.
- Higher IGF-1 levels are particularly noted in OSA patients without cognitive deficits.
- The IGF-1 response to OSA may offer a protective mechanism against neurocognitive dysfunction.
Background:
Pediatric OSA is associated with substantial morbidity in cognitive function. However, for any given OSA severity level, altered cognitive performance may or may not be present. Since IGF-1 is neuroprotective, we hypothesized that higher systemic IGF-1 levels may identify children at lower susceptibility for cognitive morbidity.
Methods:
Consecutive habitually snoring and non-snoring children ages 5-7 years were recruited from the community, and underwent overnight polysomnography, and neurocognitive testing and a blood draw the next morning. Snoring children were divided into OSA or no OSA, and OSA children were further subdivided into those with >=2 abnormal cognitive subtests and into those with normal cognitive scores. Plasma levels of IGF-1 were also measured using ELISA.
Results:
Among snoring children without OSA, circulating IGF-1 was 910 +/- 110 pg/mL compared with 1070 +/- 240 pg/mL in those with OSA (p<0.01). However, IGF-1 was 540 +/- 70 pg/mL in children with OSA and cognitive deficits, compared to 1370 +/- 170 microg/L in children with OSA and normal cognitive scores (p<0.001).
Conclusions:
IGF-1 levels are higher in children with OSA, particularly in those who do not manifest neurocognitive deficits, suggesting that the magnitude of the IGF-1 response elicited by OSA may play a significant protective role against the neurocognitive dysfunction associated with OSA.
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