Patacchioli Francesca R, Tabarrini Alessandra, Ghiciuc Cristina M, Dima-Cozma Lucia Corina, Prete Anna, Bianchini Carlotta, Nicoletti Ferdinando, Gozal David, Villa Maria P
Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy.
Pediatr Pulmonol. 2014 Nov;49(11):1145-52. doi: 10.1002/ppul.22972. Epub 2014 Jan 29.
The present pilot study was performed to evaluate the HPA axis and ANS activity by measuring salivary cortisol and α-amylase diurnal trajectory and production, respectively, in mild or moderate-to-severe (MS) OSA-affected, but otherwise healthy, children. Moreover, a correlative analysis was performed between the salivary biomarker concentrations and the PSG variables characterizing the OSA severity.
We studied 27 consecutive OSA patients (13 mild OSA; 14 MS OSA) and seven healthy children who were enrolled as controls by collecting salivary samples and measuring cortisol and α-amylase levels using enzyme-linked bioassays.
Compared with controls, both mild and MS OSA children showed: (1) increased salivary cortisol diurnal production, (2) maintenance of the physiological circadian activity of the HPA axis, and (3) no changes in α-amylase diurnal trajectory and production. In addition, morning salivary cortisol concentrations was negatively associated with the disease severity in the MS OSA group.
OSA is associated with dysregulation of the HPA axis activity in children, the latter potentially underlying some of the adverse consequences of the disease.
本初步研究旨在通过分别测量轻度或中重度（MS）阻塞性睡眠呼吸暂停（OSA）患儿（其他方面健康）唾液皮质醇和α-淀粉酶的昼夜变化轨迹及分泌量，来评估下丘脑-垂体-肾上腺（HPA）轴和自主神经系统（ANS）的活动。此外，还对唾液生物标志物浓度与表征OSA严重程度的多导睡眠图（PSG）变量进行了相关性分析。
我们连续研究了27例OSA患者（13例轻度OSA；14例MS OSA）以及7名作为对照的健康儿童，通过收集唾液样本并使用酶联免疫分析法测量皮质醇和α-淀粉酶水平。
与对照组相比，轻度和MS OSA患儿均表现为：（1）唾液皮质醇昼夜分泌量增加；（2）HPA轴的生理昼夜活动得以维持；（3）α-淀粉酶的昼夜变化轨迹和分泌量无变化。此外，MS OSA组清晨唾液皮质醇浓度与疾病严重程度呈负相关。
OSA与儿童HPA轴活动失调有关，后者可能是该疾病一些不良后果的潜在原因。
