Tauman Riva, Lavie Lena, Greenfeld Michal, Sivan Yakov
The Pediatric Sleep Center, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Lloyd Rigler Sleep Apnea Research Laboratory, Unit of Anatomy and Cell Biology, The Ruth and Bruce Rappaport Faculty of Medicine. Technion - Israel Institute of Technology, Haifa, Israel.
J Clin Sleep Med. 2014 Jun 15;10(6):677-81. doi: 10.5664/jcsm.3800.
Pediatric obstructive sleep apnea (OSA) is associated with cardiovascular consequences, including accelerated atherosclerosis and endothelial dysfunction. Increased lipid peroxidation, a marker of oxidative stress, has been identified in adults with OSA in a severity-dependent manner, with attenuation following treatment with continuous positive airway pressure therapy. Studies on oxidative stress in children with OSA are sparse and results are inconclusive. The objective of this study was to compare lipid peroxidation in children with OSA to non-OSA children.
A prospective cross-sectional study of 26 children with polysomnography-confirmed OSA (oAHI ≥ 5/h TST) was conducted. Thirty age- and body mass index z-score-matched children with primary snoring (PS) served as a comparison group (oAHI ≤ 1/h TST). Fasting blood samples were obtained on the morning following the sleep study. Plasma oxidized low-density lipoprotein (oxLDL) concentrations were measured by enzyme-linked immunosorbent assay.
There were no group differences in patient characteristics and their lipid profiles. The mean oxLDL levels of the OSA group were significantly higher than those of the comparison group (53.1 ± 13.0 vs. 45.7 ± 10.0 U/L, respectively, p = 0.02). There was a significant positive correlation between plasma oxLDL and the apnea hypopnea index (r = 0.29, p = 0.03) and between oxLDL and the oxygen desaturation index (r = 0.51, p = 0.003), and a significant negative correlation between SpO2 nadir and oxLDL (r = -0.29, p = 0.03).
OSA in children is associated with increased lipid peroxidation in a severity-dependent manner. Lipid peroxidation levels correlate with the degree of intermittent hypoxia.
儿童阻塞性睡眠呼吸暂停（OSA）与心血管后果相关，包括动脉粥样硬化加速和内皮功能障碍。脂质过氧化增加是氧化应激的一个指标，在成年OSA患者中已被确定与病情严重程度相关，持续气道正压通气治疗后可减轻。关于儿童OSA氧化应激的研究较少且结果尚无定论。本研究的目的是比较OSA儿童与非OSA儿童的脂质过氧化情况。
对26例经多导睡眠图确诊为OSA（阻塞性呼吸暂停低通气指数[oAHI]≥5次/小时总睡眠时间[TST]）的儿童进行了一项前瞻性横断面研究。30例年龄和体重指数z评分匹配的原发性打鼾（PS）儿童作为对照组（oAHI≤1次/小时TST）。在睡眠研究后的早晨采集空腹血样。采用酶联免疫吸附测定法测量血浆氧化型低密度脂蛋白（oxLDL）浓度。
两组患者的特征及其血脂谱无差异。OSA组的平均oxLDL水平显著高于对照组（分别为53.1±13.0与45.7±10.0 U/L，p = 0.02）。血浆oxLDL与呼吸暂停低通气指数之间存在显著正相关（r = 0.29，p = 0.03），oxLDL与氧去饱和指数之间也存在显著正相关（r = 0.51，p = 0.003），最低血氧饱和度（SpO2 nadir）与oxLDL之间存在显著负相关（r = -0.29，p = 0.03）。
儿童OSA与脂质过氧化增加呈病情严重程度依赖性相关。脂质过氧化水平与间歇性缺氧程度相关。
