Kheirandish-Gozal Leila, Gozal David
Section of Pediatric Sleep Medicine, Department of Pediatrics, Biological Sciences Division, Pritzker School of Medicine, The University of Chicago, Chicago, IL.
Section of Pediatric Sleep Medicine, Department of Pediatrics, Biological Sciences Division, Pritzker School of Medicine, The University of Chicago, Chicago, IL.
Chest. 2017 Feb;151(2):500-506. doi: 10.1016/j.chest.2016.09.026. Epub 2016 Oct 6.
Since initial reports 40 years ago on pediatric OSA syndrome (OSAS) as a distinct and prevalent clinical entity, substantial advances have occurred in the delineation of diagnostic and treatment approaches. However, despite emerging and compelling evidence that OSAS increases the risk for cognitive, cardiovascular, and metabolic end-organ morbidities, routine assessment of such morbidities is seldom conducted in clinical practice. One of the major reasons for such discrepancies resides in the relatively labor-intensive and onerous steps that would be required to detect the presence of any of such morbidities, further adding to the already elevated cost of diagnosing the disorder. To circumvent these obstacles, the search for biomarker signatures of pediatric OSA and its cognitive and cardiometabolic consequences was launched, and considerable progress has occurred since then. Here, we review the current evidence for the presence of morbidity-related biomarkers among children with OSAS, and explore future opportunities in this promising arena.
自40年前首次报道小儿阻塞性睡眠呼吸暂停综合征(OSAS)作为一种独特且普遍的临床实体以来,在诊断和治疗方法的界定方面取得了重大进展。然而,尽管有新出现的且令人信服的证据表明OSAS会增加认知、心血管和代谢终末器官发病的风险,但在临床实践中很少对这些发病情况进行常规评估。出现这种差异的主要原因之一在于检测任何此类发病情况所需的相对劳动密集且繁重的步骤,这进一步增加了已经高昂的疾病诊断成本。为了规避这些障碍,人们开始寻找小儿OSA及其认知和心脏代谢后果的生物标志物特征,从那时起已经取得了相当大的进展。在此,我们回顾了目前关于OSAS患儿中存在与发病相关生物标志物的证据,并探讨了这个有前景领域的未来机遇。