|
Title
|
|
|
|
C-reactive protein as a potential biomarker of residual obstructive sleep apnea following adenotonsillectomy in children
| |
|
Author
|
|
|
|
| |
|
Abstract
|
|
|
|
| Study Objectives: Adenotonsillectomy (AT) is first-line treatment for pediatric obstructive sleep apnea (OSA), with most children having improvements in polysomnography (PSG). However, many children have residual OSA following AT as determined through PSG. Identification of a biomarker of residual disease would be clinically meaningful to detect children at risk. We hypothesize serum high-sensitivity C-reactive protein (hsCRP), an inflammatory biomarker, is predictive of residual OSA following AT. Methods: PSG was performed both preoperatively and postoperatively on children undergoing AT for the diagnosis of OSA. HsCRP serum concentrations were determined in all children pre-AT, and in most children post-AT. Resolution of OSA after AT was defined by a post-AT apnea-hypopnea index (AHI) < 1.5/h total sleep time (TST). Residual OSA was defined as a post-AT AHI > 5/h TST, which is considered clinically significant. Results: AT significantly improved the AHI from 15.9 +/- 16.4 to 4.1 +/- 5.3/h TST in 182 children (P < 0.001). Of 182 children, residual OSA (post-AT AHI > 5) was seen in 46 children (25%). Among children who had hsCRP levels measured pre-and post-AT (n = 155), mean hsCRP levels pre-AT were 0.98 +/- 1.91 mg/L and were significantly reduced post-AT (0.63 +/- 2.24 mg/dL; P = 0.011). Stratification into post-AT AHI groups corresponding to < 1.5/h TST, 1.5/h TST < AHI < 5/h TST, and AHI > 5/h TST revealed post-AT hsCRP levels of 0.09 +/- 0.12, 0.57 +/- 2.28, and 1.49 +/- 3.34 mg/L with statistical significance emerging comparing residual AHI > 5/h TST compared to post-AT AHI < 1.5/h TST (P = 0.006). Hierarchical multivariate modeling confirmed that pre-AT AHI and post-AT hsCRP levels were most significantly associated with residual OSA. Conclusions: Even though AT improves OSA in most children, residual OSA is frequent. Assessment of post-AT hsCRP levels emerges as a potentially useful biomarker predicting residual OSA. |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
Sleep. - New York, N.Y., 1978, currens
| |
|
Publication
|
|
|
|
New York, N.Y.
:
2016
| |
|
ISSN
|
|
|
|
0161-8105
[print]
1550-9109
[online]
| |
|
DOI
|
|
|
|
10.5665/SLEEP.5428
| |
|
Volume/pages
|
|
|
|
39
:2
(2016)
, p. 283-291
| |
|
ISI
|
|
|
|
000368938100004
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|
Full text (publisher's version - intranet only)
|
|
|
|
| |
|