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儿童阻塞性睡眠呼吸暂停症中髓样相关蛋白 8/14 水平。

Myeloid-related protein 8/14 levels in children with obstructive sleep apnoea.

机构信息

Dept of Paediatrics, University of Chicago, Chicago, IL 60637, USA.

出版信息

Eur Respir J. 2010 Apr;35(4):843-50. doi: 10.1183/09031936.00075409. Epub 2009 Jul 16.

Abstract

Obstructive sleep apnoea (OSA) is common in children and leads to multiple end-organ morbidities. Myeloid-related protein (MRP) 8/14 plays an important pathophysiological role in atherosclerosis, and plasma levels correlate with endothelial cell dysfunction. We hypothesised that MRP8/14 levels would be altered in children with OSA. 255 children (aged 7.6+/-1.5 yrs) were included after a sleep study and a morning blood sample. MRP8/14 and interleukin-6 plasma levels were assayed using ELISA and C-reactive protein by immunoturbidometry. Endothelial function was assessed as the hyperaemic response after occlusion of the brachial artery. Plasma log MRP8/14 levels showed apnoea/hypopnoea index (AHI) dose-dependent increases regardless of obesity. Moreover, log MRP8/14 levels correlated with log AHI (r = 0.340, p<0.001) after controlling for age and body mass index Z-score, and with endothelial function. Children with the highest MRP levels (>1.34 ug x mL(-1)) had 2.4- and 5.4-fold increased odds of mild OSA and moderate-to-severe OSA, respectively, after adjusting for confounding variables. Plasma MRP8/14 levels are associated with paediatric OSA and may reflect increased risk for cardiovascular morbidity. The short- and long-term consequences of elevated MRP8/14 on cardiovascular function in the context of paediatric OSA remain to be defined.

摘要

阻塞性睡眠呼吸暂停(OSA)在儿童中很常见,可导致多种靶器官病变。髓样细胞触发受体(MRP)8/14 在动脉粥样硬化的病理生理学中发挥重要作用,其血浆水平与内皮细胞功能障碍相关。我们假设 OSA 患儿的 MRP8/14 水平会发生改变。255 名儿童(年龄 7.6+/-1.5 岁)在睡眠研究和清晨采血后纳入研究。采用 ELISA 法测定 MRP8/14 和白细胞介素-6 血浆水平,免疫比浊法测定 C 反应蛋白。通过肱动脉闭塞后充血反应评估内皮功能。无论肥胖与否,MRP8/14 血浆 log 水平均随呼吸暂停低通气指数(AHI)呈剂量依赖性增加。此外,在控制年龄和体重指数 Z 评分后,MRP8/14 水平与 AHI 呈正相关(r = 0.340,p<0.001),与内皮功能相关。MRP 水平最高(>1.34ug x mL(-1))的儿童,调整混杂变量后,发生轻度 OSA 和中重度 OSA 的几率分别增加 2.4 倍和 5.4 倍。MRP8/14 水平与儿童 OSA 相关,可能反映了心血管发病风险增加。在儿科 OSA 背景下,MRP8/14 升高对心血管功能的短期和长期影响仍有待确定。

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