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Inflammatory Milieu and Cardiovascular Homeostasis in Children With Obstructive Sleep Apnea

David F Smith1,2, Md M Hossain3, Arjan Hura2

  • 1Division of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Sleep
|February 17, 2017
PubMed

Insights

In children with obstructive sleep apnea (OSA), specific inflammatory biomarkers have opposing effects on vascular stiffness, measured by pulse transit time (PTT). These complex interactions may help maintain cardiovascular health despite OSA.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Cardiovascular Research

Background:

  • Biomarkers of atherosclerosis, including pro-inflammatory cytokines and acute phase reactants, are elevated in children with obstructive sleep apnea (OSA).
  • The relationship between these biomarkers and cardiovascular endpoints in pediatric OSA remains unclear.
  • Vascular stiffness, assessed by pulse transit time (PTT), is a key indicator of cardiovascular health.

Purpose of the Study:

  • To investigate the correlation between atherosclerosis biomarkers and PTT in children with OSA.
  • To determine whether specific biomarkers positively or negatively influence PTT.
  • To explore the diurnal variation of these biomarkers and their impact on vascular stiffness.

Main Methods:

  • Recruitment of children with OSA and matched healthy controls.
  • Measurement of pro-inflammatory cytokines and acute phase reactants at 6:00 pm and 6:00 am.
  • Polysomnography with beat-to-beat blood pressure monitoring to calculate PTT during wakefulness and sleep.

Main Results:

  • Children with OSA showed distinct diurnal patterns for biomarkers compared to controls.
  • Interleukins 6 and 8, tumor necrosis factor-α, and sCD40L shortened PTT.
  • Serum amyloid A, C-reactive protein, and adiponectin prolonged PTT, resulting in no overall group difference in PTT.

Conclusions:

  • Differential associations of acute phase reactants and pro-inflammatory cytokines with PTT were observed in children with OSA.
  • These opposing effects suggest a potential compensatory mechanism to maintain cardiovascular homeostasis.
Abstract

Keywords:
Acute phase reactantsInflammation.Pediatric obstructive sleep apneaPulse transit time

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