1 Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.
2 Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, Virginia, USA.
Otolaryngol Head Neck Surg. 2018 May;158(5):947-951. doi: 10.1177/0194599818760281. Epub 2018 Feb 27.
Objective Due to limitations of polysomnography (PSG), novel ways to evaluate pediatric obstructive sleep apnea (OSA) are needed. Urinary leukotriene E4 (LTE4), an inflammatory marker, has been identified as a potential biomarker for pediatric OSA. The objective of the study was to assess whether urinary LTE4 levels correlate with OSA severity, as determined by obstructive apnea-hypopnea index (AHI) and nadir oxygen saturation. Study Design Prospective trial. Setting Tertiary care children's hospital. Subjects and Methods Children (age, 3-16 years) with sleep-disordered breathing (SDB) who were referred for PSG were included. Urine samples were obtained the morning following PSG, and urinary LTE4 levels were quantified with enzyme-linked immunoassay kits. Results A total of 113 children were enrolled, and the mean age was 7.3 years. Thirty-nine percent (n = 44) were obese, and the majority were white (53%, n = 58). Seventy-eight percent (n = 88) were diagnosed with OSA (AHI >1), with 27% (n = 30) having severe disease (AHI >10). The mean urinary LTE4 level was 91.3 ng/mM. Urinary LTE4 levels did not correlate with AHI ( P = .77) or nadir oxygen saturation ( P = .64). There was a significant difference in urinary LTE4 levels between patients with mild SDB and those with moderate to severe OSA ( P = .03). Conclusion Urinary LTE4 levels do not correlate with AHI in children with SDB. Compared with children with severe OSA, children with mild SDB have higher urinary LTE4 levels. Further research is needed determine whether urinary LTE4 is a satisfactory biomarker for pediatric OSA.
目的 由于多导睡眠图（PSG）的局限性，需要寻找新的方法来评估儿科阻塞性睡眠呼吸暂停（OSA）。尿白三烯 E4（LTE4）作为一种炎症标志物，已被确定为小儿 OSA 的潜在生物标志物。本研究旨在评估尿 LTE4 水平与 OSA 严重程度的相关性，OSA 严重程度由阻塞性呼吸暂停-低通气指数（AHI）和最低血氧饱和度确定。 研究设计 前瞻性试验。 地点 三级儿童保健医院。 研究对象和方法 纳入患有睡眠呼吸障碍（SDB）并被转介行 PSG 的儿童。PSG 后次日清晨采集尿液样本，并使用酶联免疫吸附试剂盒定量测定尿 LTE4 水平。 结果 共纳入 113 名儿童，平均年龄为 7.3 岁。39%（n=44）为肥胖，大多数为白人（53%，n=58）。78%（n=88）被诊断为 OSA（AHI>1），其中 27%（n=30）患有严重疾病（AHI>10）。尿 LTE4 水平的平均值为 91.3ng/mM。尿 LTE4 水平与 AHI 无相关性（P=0.77）或最低血氧饱和度无相关性（P=0.64）。轻度 SDB 患者与中重度 OSA 患者的尿 LTE4 水平存在显著差异（P=0.03）。 结论 在患有 SDB 的儿童中，尿 LTE4 水平与 AHI 不相关。与患有严重 OSA 的儿童相比，患有轻度 SDB 的儿童的尿 LTE4 水平更高。需要进一步研究以确定尿 LTE4 是否是小儿 OSA 的理想生物标志物。
