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  •   University of Thessaly Institutional Repository
  • Επιστημονικές Δημοσιεύσεις Μελών ΠΘ (ΕΔΠΘ)
  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ.
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  •   University of Thessaly Institutional Repository
  • Επιστημονικές Δημοσιεύσεις Μελών ΠΘ (ΕΔΠΘ)
  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ.
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C-reactive protein as a potential biomarker of residual obstructive sleep apnea following adenotonsillectomy in children

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Author
Bhattacharjee R., Kheirandish-Gozal L., Kaditis A.G., Verhulst S.L., Gozal D.
Date
2016
Language
en
DOI
10.5665/sleep.5428
Keyword
C reactive protein
biological marker
C reactive protein
adenotonsillectomy
adult
apnea hypopnea index
Article
child
childhood disease
diagnostic test accuracy study
female
human
major clinical study
male
minimal residual disease
obesity
polysomnography
postoperative period
prediction
preoperative period
preschool child
priority journal
residual obstructive sleep apnea
sensitivity and specificity
sleep disordered breathing
sleep time
total sleep time
adenoidectomy
metabolism
pathophysiology
risk
Sleep Apnea, Obstructive
tonsillectomy
Adenoidectomy
Biomarkers
C-Reactive Protein
Child
Female
Humans
Male
Polysomnography
Postoperative Period
Risk
Sleep Apnea, Obstructive
Tonsillectomy
Associated Professional Sleep Societies,LLC
Metadata display
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.
URI
http://hdl.handle.net/11615/71637
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  • Δημοσιεύσεις σε περιοδικά, συνέδρια, κεφάλαια βιβλίων κλπ. [19705]

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