Department of Family Medicine, Metabolism and Obesity Institute, Sleep Center, Chang Gung Memorial Hospital, Taipei and Linkou Branches, Taoyuan 33305, Taiwan.
School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
Int J Mol Sci. 2024 Aug 16;25(16):8951. doi: 10.3390/ijms25168951.
Children with obstructive sleep apnea (OSA) frequently experience chronic low-grade systemic inflammation, with the inflammasome playing a central role in OSA. This cross-sectional study evaluated the relationship between weight status, autonomic function, and systemic inflammation in a cohort of 55 children with OSA, predominantly boys (78%) with an average age of 7.4 ± 2.2 years and an apnea-hypopnea index of 14.12 ± 17.05 events/hour. Measurements were taken of body mass index (BMI), sleep heart-rate variability, morning circulatory levels of interleukin-1β, interleukin-1 receptor antagonist, and interleukin-6, and tumor necrosis factor-α, anthropometry, and polysomnography. Multiple linear regression modeling showed that an apnea-hypopnea index was significantly associated with BMI, the standard deviation of successive differences between normal-to-normal intervals during N3 sleep, and the proportion of normal-to-normal interval pairs differing by more than 50 ms during rapid-eye-movement sleep. A moderated mediation model revealed that interleukin-1 receptor antagonist levels mediated the association between BMI and interleukin-6 levels, with sympathovagal balance during N3 sleep and minimum blood oxygen saturation further moderating these relationships. This study highlights the complex relationships between BMI, polysomnographic parameters, sleep heart-rate-variability metrics, and inflammatory markers in children with OSA, underlining the importance of weight management in this context.
患有阻塞性睡眠呼吸暂停（OSA）的儿童经常经历慢性低度全身炎症，其中炎性小体在 OSA 中发挥核心作用。这项横断面研究评估了体重状况、自主神经功能和全身炎症之间的关系，研究对象是 55 名患有 OSA 的儿童，其中大多数为男孩（78%），平均年龄为 7.4 ± 2.2 岁，呼吸暂停低通气指数为 14.12 ± 17.05 次/小时。测量了体重指数（BMI）、睡眠心率变异性、早晨循环中白细胞介素-1β、白细胞介素-1 受体拮抗剂和白细胞介素-6、肿瘤坏死因子-α、人体测量学和多导睡眠图。多元线性回归模型显示，呼吸暂停低通气指数与 BMI、N3 睡眠中正常到正常间隔的连续差异的标准差以及快速眼动睡眠中正常到正常间隔对差异超过 50ms 的比例显著相关。一个调节中介模型显示，白细胞介素-1 受体拮抗剂水平介导了 BMI 和白细胞介素-6 水平之间的关联，N3 睡眠期间的交感神经和迷走神经平衡以及最低血氧饱和度进一步调节了这些关系。这项研究强调了患有 OSA 的儿童中 BMI、多导睡眠图参数、睡眠心率变异性指标和炎症标志物之间复杂的关系，突出了在这种情况下进行体重管理的重要性。
