Role of Adenotonsillectomy and Tonsillectomy in Children with Down Syndrome Who Develop Obstructive Sleep Apnea by Obesity as a Risk Factor

Exploring the Link between Oxidative Stress, Selenium Levels, and Obesity in Youth

Obesity is a worldwide increasing concern. Although in adults this is easily estimated with the body mass index, in children, who are constantly growing and whose bodies are changing, the reference points to assess weight status are age and gender, and need corroboration with complementary data, making their quantification highly difficult. The present review explores the interaction spectrum of oxidative stress, selenium status, and obesity in children and adolescents. Any factor related to oxidative stress that triggers obesity and, conversely, obesity that induces oxidative stress are part of a vicious circle, a complex chain of mechanisms that derive from each other and reinforce each other with serious health consequences. Selenium and its compounds exhibit key antioxidant activity and also have a significant role in the nutritional evaluation of obese children. The balance of selenium intake, retention, and metabolism emerges as a vital aspect of health, reflecting the complex interactions between diet, oxidative stress, and obesity. Understanding whether selenium status is a contributor to or a consequence of obesity could inform nutritional interventions and public health strategies aimed at preventing and managing obesity from an early age.

Development and validation of a scale for the assessment of the knowledge-attitude-practice of parents towards children snoring

BACKGROUND

Children Snoring is a common childhood disorder that affects the growth and development of children and is detrimental to their health. Increasing awareness of Children Snoring among parents is important.

AIM

To develop the Knowledge-Attitude-Practice of Parents towards Children Snoring Scale and test the reliability and validity of the scale.

METHODS

The development of the tool was divided into two phases involving 1257 parents from China. In the first phase, an initial project bank was created through a literature review. This was followed by a Delphi expert consultation, group discussion and pre-survey. The second stage screened the items and conducted an exploratory factor analysis, then conducted a confirmatory factor analysis and tested for reliability and validity.

RESULTS

Support was found for the 25-item Knowledge-Attitude-Practice toward Children Snoring scale. Exploratory and confirmatory factor analyses provide support for four subscales: (parental basic cognition toward Children Snoring; parents' perception of complications of Children Snoring; parents' attitude towards Children Snoring; parents' concern and prevention of Children Snoring). Internal consistency for the total scale was high (Cronbach's α = 0.93). The intraclass correlation coefficient of test-retest reliability was 0.92 (95%CI: 0.85 to 0.95), which provided support for the stability of the scale.

CONCLUSION

The Knowledge-Attitude-Practice of Parents towards Children Snoring scale shows promise as a measure that may be used by medical workers and community children's health managers.

Oxygen desaturation index, lowest arterial oxygen saturation and time spent below 90% oxygen saturation as diagnostic markers for obstructive sleep apnea

BACKGROUND

Obstructive sleep apnea (OSA) syndrome is associated with a high mortality, and blood oxygen indexes play an important role in evaluating this disease. The objective of this study was to explore the value of blood oxygen indexes, including minimum oxygen saturation (LSpO2), oxygen reduction index (ODI) and time spent with oxygen saturation below 90% (TS 90%), as diagnostic markers for OSA syndrome.

METHODS

In this retrospective study, 320 patients with OSA treated in Ningbo First Hospital from June 2018 to June 2021 were included and divided into mild, moderate, and severe groups according to the severity of the condition (n = 104, 92, and 124, respectively). The blood oxygen indexes as well as the apnea-hypopnea index (AHI) were compared. The Spearman correlation analysis was performed to explore the relationship between the parameters. Receiver operating characteristic curves were generated to evaluate the diagnostic value of the blood oxygen indexes for OSA syndrome.

RESULTS

There were significant differences in body weight, body mass index, and blood pressure before and after sleep among the groups (P < 0.05). LSpO2 levels followed a pattern with the severe group showing the lowest values, followed by the moderate group, and then the mild group, whereas ODI and TS 90% levels showed the opposite (P < 0.05). Spearman correlation analysis showed that AHI, ODI, TS 90% were positively correlated with severity of OSA, whereas LSpO2 was negatively correlated with severity of OSA. ODI showed a high diagnostic value for OSA (area under curve (AUC) = 0.823, 95% CI: 0.730-0.917). TS 90% showed a high diagnostic value for OSA (AUC = 0.872, 95% CI: 0.794-0.950). LSpO2 showed high accuracy in diagnostic value for OSA (AUC = 0.716, 95% CI: 0.596-0.835). The combination of the 3 indexes demonstrated a high diagnostic value for OSA (AUC = 0.939, 95% CI: 0.890-0.989). The diagnostic value of the combined signature was found to be significantly higher compared to the value of individual indexes (P < 0.05).

CONCLUSION

The evaluation of the severity of OSA should not rely solely on a single observation index, but rather on a combination of ODI, LSpO2 and TS 90%. This combined diagnostic signature can provide a more comprehensive assessment of the patient's condition and serve as an alternative diagnostic basis to ensure timely diagnosis and appropriate clinical treatment for OSA.

Effect of Genetic Variations in the ADIPOQ Gene on Susceptibility to Type 2 Diabetes Mellitus

BACKGROUND

ADIPOQ (adiponectin) affects fatty acid oxidation, glucose uptake, and glycogenesis, all of which are involved in the development of diabetes. As a result, ADIPOQ is being studied as a potential gene for type 2 diabetes mellitus (T2DM), which is a polygenic disease with genetic inheritance. This study aims to investigate the genetic variants (rs17846866 and rs1501299) in ADIPOQ gene with T2DM in the Saudi population.

METHODS

In this study, T2DM patients (n=96) and healthy controls (n=96) were recruited for molecular analysis for rs17846866 and rs1501299 single nucleotide polymorphisms (SNPs). Clinical data were analyzed using t-tests, HWE analysis, and genotype and allele frequencies were calculated for the rs17846866 and rs1501299 SNPs between T2DM cases and controls. ANOVA analysis was also used to investigate the relationship between the SNPs rs17846866 and rs1501299 and T2DM characteristics.

RESULTS

The current study results confirmed a positive association between clinical characteristics, HWE analysis, genotype, and allele frequencies in both rs17846466 and rs1501299 SNPs (p<0.05). In T2DM patients, ANOVA analysis with rs17846466 and rs1501299 SNPs in the ADIPOQ gene has no effect on any of the involved parameters (p>0.05).

CONCLUSION

This study concludes as rs17846866 and rs1501299 SNPs were strongly associated in the Saudi population with T2DM patients.