Obstructive sleep apnoea and obesity

The evaluation of adenotonsillectomy on TNF-α and IL-6 levels in obese children with obstructive sleep apnea

OBJECTIVE

(1) To evaluate the effect of adenotonsillectomy (T&A) on clinical signs in obese children with obstructive sleep apnea (OSA); (2) to evaluate the changes in tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 levels pre- and post-surgery; and (3) to determine a potential explanation for changes in cytokine levels after T&A therapy.

SUBJECTS AND METHODS

In brief, 90 obese children with OSA were enrolled. Polysomnographic data, such as an apnea-hypopnea index (AHI) and oxyhemoglobin saturation (SaO₂), and demographic information, such as body mass index (BMI), were collected. TNF-α and IL-6 levels were determined before and 6 months after T&A treatment.

RESULTS

It was observed that 61.1% of obese children with OSA were persistent after T&A therapy. In general, AHI (events/h) measures decreased from 22.26 ± 9.141 to 8.88 ± 5.909 before and after a 6-month follow-up period, respectively, and nadir SaO₂ (%) levels increased from 74.26 ± 7.486 to 86.37 ± 5.578 pre- and post-surgery, respectively. However, no discernible differences in BMI measures before and after a 6-month follow-up period (40.996 ± 5.2486 vs. 40.597 ± 5.0540) were observed. No significant differences in the TNF-α and IL-6 levels pre- and post-surgery were observed. TNF-α and IL-6 plasma levels were highly correlated with BMI measurements (TNF-α: r(2)=0.2350, P<0.001; IL-6: r(2)=0.6629, P<0.001). In contrast, there was no association between plasma levels and AHI measures (TNF-α: r(2)=0.03377, P=0.0829; IL-6: r(2)=0.03946, P=0.0605).

CONCLUSION

T&A therapy can improve clinical symptoms and signs but is not a cure for the treatment of obese children with OSA. The inflammation levels of TNF-α and IL-6 changed little. To reduce the risk for excessive daytime sleepiness, supplementary therapies should be introduced for OSA.