Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, No.157, Xiwu Road, Xi'an, 710004, Shaanxi, People's Republic of China.
Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, Shaanxi, China.
BMC Pediatr. 2022 Jul 26;22(1):449. doi: 10.1186/s12887-022-03514-9.
In children, obstructive sleep apnea (OSA) can cause cognitive dysfunctions. Amyloid-beta and tau are elevated in OSA. Neurofilament light (NfL) is a marker of neuro-axonal damage, but there are no reports of NfL for OSA. The objective was to investigate the serum levels of NfL and tau in children with or without OSA and explore their relationship with cognitive dysfunctions caused by OSA.
This retrospective case-control study included children diagnosed with adenoid tonsil hypertrophy from July 2017 to September 2019 at the Second Affiliated Hospital of Xi'an Jiaotong University. Correlations between cognitive scores and tau and NfL were examined.
Fifty-six OSA and 49 non-OSA children were included. The serum NfL levels were higher in the OSA group (31.68 (27.29-36.07) pg/ml) than in the non-OSA group (19.13 (17.32-20.95) pg/ml) (P < 0.001). Moreover, NfL was correlated with the course of the disease, apnea-hypopnea index (AHI), obstructive apnea index (OAI), obstructive apnea-hypopnea index (OAHI), average oxygen saturation (SaO), respiratory arousal index (RAI), and cognitive dysfunctions evaluated by the Chinese Wechsler Intelligence Scale for Children (C-WISC) (all P < 0.05). The area under the receiver operating characteristics curve (AUC) of NfL was 0.816 (95%CI: 0.736-0.897). Multiple regression analysis revealed that NfL was significantly associated with verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ) and full-scale intelligence quotient (FIQ) (P < 0.001, respectively).
Serum NfL levels are associated with the severity of cognitive dysfunctions in children diagnosed with adenoid tonsil hypertrophy and might be a candidate noninvasive, objective marker to identify cognitive dysfunctions in children with OSA.
在儿童中，阻塞性睡眠呼吸暂停（OSA）可导致认知功能障碍。淀粉样β和tau 在 OSA 中升高。神经丝轻链（NfL）是神经轴突损伤的标志物，但尚无关于 OSA 的 NfL 报告。本研究旨在探讨伴有或不伴有 OSA 的儿童血清 NfL 和 tau 水平，并探讨其与 OSA 引起的认知功能障碍的关系。
这是一项回顾性病例对照研究，纳入了 2017 年 7 月至 2019 年 9 月在西安交通大学第二附属医院诊断为腺样体扁桃体肥大的儿童。检查了认知评分与 tau 和 NfL 之间的相关性。
纳入了 56 例 OSA 患儿和 49 例非 OSA 患儿。OSA 组血清 NfL 水平（31.68（27.29-36.07）pg/ml）高于非 OSA 组（19.13（17.32-20.95）pg/ml）（P<0.001）。此外，NfL 与疾病病程、呼吸暂停低通气指数（AHI）、阻塞性呼吸暂停指数（OAI）、阻塞性呼吸暂停低通气指数（OAHI）、平均氧饱和度（SaO）、呼吸觉醒指数（RAI）以及中国韦氏儿童智力量表（C-WISC）评估的认知功能障碍均相关（均 P<0.05）。NfL 的受试者工作特征曲线（ROC）下面积（AUC）为 0.816（95%CI：0.736-0.897）。多因素回归分析显示，NfL 与言语智商（VIQ）、操作智商（PIQ）和全智商（FIQ）显著相关（P<0.001）。
血清 NfL 水平与诊断为腺样体扁桃体肥大的儿童认知功能障碍的严重程度相关，可能是一种非侵入性、客观的标志物，可用于识别 OSA 儿童的认知功能障碍。
