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Published on: December 6, 2016
Vitamin D and Mean Platelet Volume as Biomarkers in Pediatric Obstructive Sleep Apnea: Associations with Disease
Anna Di Sessa1, Giuditta Bargiacchi2, Ludovica Nucci2
1Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Insights
Low vitamin D and high mean platelet volume (MPV) are linked to pediatric obstructive sleep apnea (OSA). Vitamin D levels correlate with sleep disturbances and OSA severity, suggesting their potential as biomarkers.
Area of Science:
- Pediatric Sleep Medicine
- Endocrinology
- Hematology
Background:
- Vitamin D and mean platelet volume (MPV) are potential biomarkers for adult obstructive sleep apnea (OSA).
- Limited pediatric data exist regarding the association of vitamin D and MPV with OSA.
- Investigating these biomarkers in children is crucial for understanding pediatric OSA.
Purpose of the Study:
- To examine the relationship between vitamin D, MPV, and the presence/severity of pediatric OSA.
- To explore correlations between vitamin D status and sleep parameters in children with OSA.
Main Methods:
- 138 children with polysomnography-confirmed OSA and 138 matched controls were enrolled.
- Participants underwent clinical, biochemical, and sleep assessments.
- The OSA group was stratified by disease severity.
Main Results:
- Children with OSA had significantly lower vitamin D levels and higher MPV, CRP, and ESR compared to controls.
- Severe OSA correlated with increased inflammation, insulin resistance, and lower vitamin D.
- Lower vitamin D levels were independently associated with higher odds of OSA and correlated with increased Apnea-Hypopnea Index and Oxygen Desaturation Index.
Conclusions:
- Vitamin D and MPV are associated with pediatric OSA presence and severity.
- Vitamin D levels correlate with specific sleep architecture parameters in children with OSA.
- MPV may reflect OSA-associated inflammation, supporting the potential utility of vitamin D and MPV as pediatric OSA biomarkers.
Abstract:
Background/Objectives: Vitamin D and mean platelet volume (MPV) have been suggested as biomarkers of obstructive sleep apnea (OSA) in adults, while pediatric data remain limited. We aimed (i) to investigate associations between vitamin D and MPV with the presence and severity of pediatric OSA and (ii) to explore potential associations between vitamin D status and sleep parameters in normal-weight affected children. Methods: A total of 138 children with polysomnography-confirmed OSA and 138 age- and sex-matched controls were enrolled. All participants underwent detailed clinical, biochemical, and overnight sleep assessments. The OSA group was stratified according to disease severity. Results: Vitamin D levels were significantly lower in OSA patients (p < 0.0001), while MPV, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were significantly higher (all p < 0.0001) than in the controls. Severe OSA was associated with elevated inflammation markers, higher insulin resistance, and lower vitamin D levels (all p < 0.0001). Vitamin D levels were inversely associated with the Apnea-Hypopnea Index (AHI) (R 0.37, adjusted r2 0.13, p < 0.0001) and Oxygen Desaturation Index (ODI) (R 0.36, adjusted r2 0.13, p < 0.0001), even after adjustments (both p < 0.0001). N1 and REM sleep were negatively associated with vitamin D in the OSA group (p = 0.01 and p = 0.02, respectively). Vitamin D deficiency was independently associated with higher odds of OSA (adjusted OR = 6.76, 95% CI: 3.97-11.51, p < 0.0001). Similarly, OSA presence was associated with lower vitamin D levels (aOR = 1.40, 95% CI: 1.06-1.94, p = 0.03). Conclusions: Vitamin D and MPV are associated with the presence and severity of pediatric OSA. Vitamin D levels were related to specific sleep architecture parameters, and MPV appeared to reflect inflammation associated with OSA, supporting their potential utility as biomarkers in pediatric OSA.
