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Lei L, Zhang X, Wang B, Lei F, Dai L, Sun X, Zhao Y, Zhu P, Zou J. Effects of sleep-disordered breathing on serum lipid levels in children:a case control study. BMC Pediatr 2024; 24:220. [PMID: 38561714 PMCID: PMC10983664 DOI: 10.1186/s12887-024-04577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/19/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Sleep-disordered breathing (SDB) during childhood is common and includes a range of breathing abnormalities that range from primary snoring (PS) to obstructive sleep apnea syndrome (OSAS).Studies have shown that not only OSAS, but also PS, which is originally considered harmless, could cause cardiovascular, cognitive, behavioral, and psychosocial problems. Many researches are focused on the relation of OSA and serum lipid levels. However, little studies are focused on PS and serum lipid levels in children.We evaluated whether serum lipid (total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C)) concentrations were associated with specific components of SDB, including indices of oxygen reduction index, lowest oxygen saturation, mean oxygen saturation. And we explored whether serum lipid levels were associated with different degree sleep disordered (PS and OSA group) and obese. METHODS This was a cross-sectional study. Children who were complained by their guardians with habitual snoring and(or) mouth breathing were collected in the SDB group. Normal children without sleep problem were matched in the control group. Subjects in the SDB group underwent polysomnography. The serum lipid profiles of all the children included TC, TG, HDL-C and LDL-C concentrations were measured by appropriate enzymatic assays. RESULTS A total of 241 with Apnea/Hypopnea Index ≥ 5 (AHI) were assigned to the OSAS group and the remaining 155 with normal AHI were assigned to the PS group. The values of TC, TG, LDL-C and LDL/HDL were significantly higher in the OSAS group than in the PS group, and the values in the PS group were significantly higher than the control group. Multiple regression analysis revealed serum TG only correlated negatively with lowest oxygen saturation. Body mass index-z score has a positive effect on TG in all the 1310 children (P = 0.031) and in SDB 396 children(P = 0.012). The level of serum TG in obese group was significantly higher than that in non-obese group. CONCLUSIONS SDB had a very obvious effect on blood lipids, whereas PS without apnea and hypoxia. Obese only affects the aggregation of TG. TRIAL REGISTRATION ChiCTR1900026807(2019.10.23).
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Affiliation(s)
- Lei Lei
- Department of Otorhinolaryngology, Head&Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
| | - XiaoYun Zhang
- Department of Otorhinolaryngology, Head&Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
| | - Binbin Wang
- Department of Otorhinolaryngology, Head&Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
| | - Fei Lei
- Department of Sleep Medical Center, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
| | - Li Dai
- West China Medical School, Sichuan University, Sichuan, China
| | - Xiaoru Sun
- Department of Otorhinolaryngology, Head&Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
| | - Yu Zhao
- Department of Otorhinolaryngology, Head&Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
| | - Ping Zhu
- Department of Clinical Research Management, West China Hospital, Sichuan University, Sichuan, China
| | - Jian Zou
- Department of Otorhinolaryngology, Head&Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Sichuan, China.
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Zatoński T, Pazdro-Zastawny K, Kolator M, Krajewska J, Basiak-Rasała A, Górna S, Zatoński M. A study on health and the association between overweight/obesity and otorhinolaryngological diseases in 6- to 17-year-old children from Wroclaw, Poland. Arch Med Sci 2022; 18:413-421. [PMID: 35316915 PMCID: PMC8924849 DOI: 10.5114/aoms.2020.97285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 07/21/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Childhood overweight and obesity have become a global problem in the past three decades. There are very few studies which examine the correlation between body mass index (BMI) and the development of otorhinolaryngological diseases in children. The objective of the study was to determine the association between overweight or obesity in children and the occurrence of otorhinolaryngological diseases. MATERIAL AND METHODS The survey study was based on a parent-reported multidisciplinary questionnaire on children's medical status among elementary and junior high school children in the city of Wroclaw, the capital city of Poland's Lower Silesia region. The children were taking part in the pro-health campaign "Let's Get the Kids Moving". RESULTS The study was conducted among 2,913 children. A statistically significant correlation was observed between the assessment of the children's BMI and the occurrence of adenoid hypertrophy. Adenoid hypertrophy was more common in the overweight and obese children. The children with adenoid hypertrophy had higher BMI than the children without adenoid hypertrophy. There was a statistically significant correlation between BMI and the incidence of adenoidectomy. There was a statistically significant correlation between BMI and the incidence of tonsillectomy. CONCLUSIONS The development and introduction of preventive programs like "Let's Get the Kids Moving" in the future will contribute to building a healthier society. The study findings suggest that primal prevention may lead to a decrease in the development of otorhinolaryngological diseases. We also showed that higher body mass correlates with higher prevalence of otorhinolaryngological diseases. Further studies are needed to establish the etiopathology of this association.
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Affiliation(s)
| | | | | | | | | | - Sara Górna
- Wroclaw Medical Univeristy, Wroclaw, Poland
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Krajewska Wojciechowska J, Krajewski W, Zatoński T. The Association Between ENT Diseases and Obesity in Pediatric Population: A Systemic Review of Current Knowledge. EAR, NOSE & THROAT JOURNAL 2019; 98:E32-E43. [PMID: 30966807 DOI: 10.1177/0145561319840819] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Obesity in pediatric population is an important global problem. The prevalence of obesity in children is dramatically rising. According to World Health Organization, about 41 million children under the age of 5 years are obese or overweight worldwide. Overweight and obesity are well-known risk factors for a number of health disorders. Diseases commonly observed in this group of patients are metabolic disorders, type 2 diabetes mellitus, cardiovascular diseases, fatty liver disease, musculoskeletal problems, and many others. The main aim of this study was to present the current knowledge of the association between childhood obesity and common otorhinolaryngological disorders. It is suggested that obese children are more prone to suffer from otorhinolaryngological illnesses than the lean ones. Obesity may predispose to otorhinolaryngological diseases in various ways. It strongly interferes with the immune system (increases serum levels of interleukin 6, tumor necrosis factor, C-reactive protein, and leptin and reduces adiponectin concentration) affecting organs of the upper respiratory tract. Additionally, obesity induces mechanical disorders in the upper airways. According to our review, obesity predisposes to otitis media with effusion, acute otitis media, recurrent otitis media, obstructive sleep apnea, sensorineural hearing loss, adenotonsillar hypertrophy, and post-/perioperative complications after adenotonsillectomy. Obesity in children significantly correlates with both obstructive sleep apnea (OSA) and asthma and constitutes a significant component of "OSA, obesity, asthma" triad.
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Affiliation(s)
| | - Wojciech Krajewski
- 2 Department and Clinic of Urology, Medical University in Wrocław, Wrocław, Poland
| | - Tomasz Zatoński
- 1 Department and Clinic of Otolaryngology, Head and Neck Surgery, Medical University in Wrocław, Wrocław, Poland
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Shaaker M, Mehdizadeh A, Ezzeddini R, Ghasemi B, Jabbari Moghaddam Y, Abdollahi Fakhim S, Saleh Moghaddam M, Darabi M. The study of serum and tissue cholesterol levels in children undergoing tonsillectomy. THE JOURNAL OF QAZVIN UNIVERSITY OF MEDICAL SCIENCES 2018. [DOI: 10.29252/qums.22.4.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Abara S. EL NIÑO QUE RONCA: IMPORTANCIA Y MANEJO. REVISTA MÉDICA CLÍNICA LAS CONDES 2017. [DOI: 10.1016/j.rmclc.2017.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kheirandish-Gozal L, Gozal D. Pediatric OSA Syndrome Morbidity Biomarkers: The Hunt Is Finally On! Chest 2016; 151:500-506. [PMID: 27720883 DOI: 10.1016/j.chest.2016.09.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 09/12/2016] [Accepted: 09/27/2016] [Indexed: 12/31/2022] Open
Abstract
Since initial reports 40 years ago on pediatric OSA syndrome (OSAS) as a distinct and prevalent clinical entity, substantial advances have occurred in the delineation of diagnostic and treatment approaches. However, despite emerging and compelling evidence that OSAS increases the risk for cognitive, cardiovascular, and metabolic end-organ morbidities, routine assessment of such morbidities is seldom conducted in clinical practice. One of the major reasons for such discrepancies resides in the relatively labor-intensive and onerous steps that would be required to detect the presence of any of such morbidities, further adding to the already elevated cost of diagnosing the disorder. To circumvent these obstacles, the search for biomarker signatures of pediatric OSA and its cognitive and cardiometabolic consequences was launched, and considerable progress has occurred since then. Here, we review the current evidence for the presence of morbidity-related biomarkers among children with OSAS, and explore future opportunities in this promising arena.
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Affiliation(s)
- Leila Kheirandish-Gozal
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Biological Sciences Division, Pritzker School of Medicine, The University of Chicago, Chicago, IL.
| | - David Gozal
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Biological Sciences Division, Pritzker School of Medicine, The University of Chicago, Chicago, IL
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Abstract
Obstructive sleep apnoea (OSA) is one of the most common causes of sleep-disordered breathing (SDB) in children. It is associated with significant morbidity, potentially impacting on long-term neurocognitive and behavioural development, as well as cardiovascular outcomes and metabolic homeostasis. The low grade systemic inflammation and increased oxidative stress seen in this condition are believed to underpin the development of these OSA-related morbidities. The significant variance in degree of end organ morbidity in patients with the same severity of OSA highlights the importance of the interplay of genetic and environmental factors in determining the overall OSA phenotype. This review seeks to summarize the current understanding of the aetiology and mechanisms underlying OSA, its risk factors, diagnosis and treatment.
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Affiliation(s)
- Eleonora Dehlink
- 1 Department of Pediatric Respiratory Medicine, Royal Brompton Hospital, London, UK ; 2 National Heart and Lung Institute, Imperial College, London, UK
| | - Hui-Leng Tan
- 1 Department of Pediatric Respiratory Medicine, Royal Brompton Hospital, London, UK ; 2 National Heart and Lung Institute, Imperial College, London, UK
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Patacchioli FR, Tabarrini A, Ghiciuc CM, Dima-Cozma LC, Prete A, Bianchini C, Nicoletti F, Gozal D, Villa MP. Salivary biomarkers of obstructive sleep apnea syndrome in children. Pediatr Pulmonol 2014; 49:1145-52. [PMID: 24474530 DOI: 10.1002/ppul.22972] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 11/03/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The present pilot study was performed to evaluate the HPA axis and ANS activity by measuring salivary cortisol and α-amylase diurnal trajectory and production, respectively, in mild or moderate-to-severe (MS) OSA-affected, but otherwise healthy, children. Moreover, a correlative analysis was performed between the salivary biomarker concentrations and the PSG variables characterizing the OSA severity. METHODS We studied 27 consecutive OSA patients (13 mild OSA; 14 MS OSA) and seven healthy children who were enrolled as controls by collecting salivary samples and measuring cortisol and α-amylase levels using enzyme-linked bioassays. RESULTS Compared with controls, both mild and MS OSA children showed: (1) increased salivary cortisol diurnal production, (2) maintenance of the physiological circadian activity of the HPA axis, and (3) no changes in α-amylase diurnal trajectory and production. In addition, morning salivary cortisol concentrations was negatively associated with the disease severity in the MS OSA group. CONCLUSIONS OSA is associated with dysregulation of the HPA axis activity in children, the latter potentially underlying some of the adverse consequences of the disease.
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Affiliation(s)
- Francesca R Patacchioli
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
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Abstract
Obstructive sleep apnea (OSA) in children is a highly prevalent disorder caused by a conglomeration of complex pathophysiological processes, leading to recurrent upper airway dysfunction during sleep. The clinical relevance of OSA resides in its association with significant morbidities that affect the cardiovascular, neurocognitive, and metabolic systems. The American Academy of Pediatrics recently reiterated its recommendations that children with symptoms and signs suggestive of OSA should be investigated with polysomnography (PSG), and treated accordingly. However, treatment decisions should not only be guided by PSG results, but should also integrate the magnitude of symptoms and the presence or absence of risk factors and signs of OSA morbidity. The first-line therapy in children with adenotonsillar hypertrophy is adenotonsillectomy, although there is increasing evidence that medical therapy, in the form of intranasal steroids or montelukast, may be considered in mild OSA. In this review, we delineate the major concepts regarding the pathophysiology of OSA, its morbidity, diagnosis, and treatment.
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Affiliation(s)
- Hui-Leng Tan
- Sections of Pediatric Sleep Medicine and Pediatric Pulmonology, Department of Pediatrics, Comer Children’s Hospital, Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
- Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
| | - David Gozal
- Sections of Pediatric Sleep Medicine and Pediatric Pulmonology, Department of Pediatrics, Comer Children’s Hospital, Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - Leila Kheirandish-Gozal
- Sections of Pediatric Sleep Medicine and Pediatric Pulmonology, Department of Pediatrics, Comer Children’s Hospital, Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
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