Feng Yani, Ma Lina, Chen Xi, Zhang Yitong, Cao Zine, Yuan Yuqi, Xie Yushan, Liu Haiqin, Shi Yewen, Ren Xiaoyong
Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Pediatr. 2023 Jan 5;10:1027894. doi: 10.3389/fped.2022.1027894. eCollection 2022.
As an important neuroprotective factor, the brain-derived neurotrophic factor (BDNF) may have a key role in cognitive impairment in children with sleep-disordered breathing (SDB). The main aim of this study was to compare the levels of BDNF and tyrosine kinase receptor B (TrkB) in normal children and those with obstructive sleep apnea (OSA) and primary snoring (PS) and to explore a possible link between BDNF/TrkB, inflammation, and SDB with cognitive impairment in children.
A total of 44 OSA children and 35 PS children who completed polysomnography between October 2017 and October 2019 were enrolled. At the same time, 40 healthy children during the same period were included as a control. Enzyme-linked immunosorbent assay was used to measure serum indices of BDNF, TrkB, interleukin-1beta (IL-1β), and tumor necrosis factor-alpha (TNF-α). Correlation and pooled analyses were performed between the cognitive scores and four serological indicators. Logistic regression was used to analyze the risk factors for cognitive impairment.
Significant differences were found in serum BDNF, TrkB, IL-1β, and TNF-α between the three groups (all < 0.01). The serum BDNF and TrkB in the OSA and PS groups were lower than those in the control group, whereas the serum IL-1β and TNF-α were higher than those in the control group (all < 0.05). Moreover, among these four indices, the strongest correlation was found between BDNF and the Chinese Wechsler Intelligence Scale (all < 0.05). Logistic regression analysis revealed a correlation between OSA status, TrkB, and course of mouth breathing and cognitive status.
The levels of serum BDNF and TrkB were related to cognitive impairment in children with SDB. Also, BDNF and TrkB could be used as noninvasive and objective candidate markers and predictive indices of cognitive impairment in children with SDB.
作为一种重要的神经保护因子,脑源性神经营养因子(BDNF)可能在睡眠呼吸障碍(SDB)儿童的认知障碍中起关键作用。本研究的主要目的是比较正常儿童与阻塞性睡眠呼吸暂停(OSA)和原发性打鼾(PS)儿童的BDNF和酪氨酸激酶受体B(TrkB)水平,并探讨BDNF/TrkB、炎症和SDB与儿童认知障碍之间的可能联系。
纳入2017年10月至2019年10月期间完成多导睡眠图检查的44例OSA儿童和35例PS儿童。同时,纳入同期40例健康儿童作为对照。采用酶联免疫吸附测定法检测血清BDNF、TrkB、白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)指标。对认知评分与四项血清学指标进行相关性和汇总分析。采用逻辑回归分析认知障碍的危险因素。
三组间血清BDNF、TrkB、IL-1β和TNF-α存在显著差异(均P<0.01)。OSA组和PS组的血清BDNF和TrkB低于对照组,而血清IL-1β和TNF-α高于对照组(均P<0.05)。此外,在这四项指标中,BDNF与中国韦氏智力量表之间的相关性最强(均P< 0.05)。逻辑回归分析显示OSA状态、TrkB和口呼吸病程与认知状态之间存在相关性。
血清BDNF和TrkB水平与SDB儿童的认知障碍有关。此外,BDNF和TrkB可作为SDB儿童认知障碍的非侵入性客观候选标志物和预测指标。