Bluher Andrew E, Kearney Timothy, Vazifedan Turaj, Baldassari Cristina M
Division of Pediatric Otolaryngology, Nemours Children's Hospital, Wilmington, Delaware.
Department of Otolaryngology, Thomas Jefferson University, Philadelphia, Pennsylvania.
JAMA Otolaryngol Head Neck Surg. 2025 Jan 1;151(1):72-77. doi: 10.1001/jamaoto.2024.3737.
Prior research has demonstrated an association between vitamin D deficiency and obstructive sleep apnea (OSA) in adults; however, its association with pediatric OSA is emerging.
To evaluate the association of vitamin D levels with obstructive Apnea-Hypopnea Index (AHI) in children with OSA.
DESIGN, SETTINGS, AND PARTICIPANTS: This was a cross-sectional study of children aged 2 to 16 years with severe obstructive OSA (AHI ≥20 on polysomnogram) who were undergoing adenotonsillectomy at a tertiary care pediatric otolaryngology clinic from 2017 to 2022. Age, sex, race, body mass index, history of asthma, and season were considered in the analyses. Data were analyzed from September 3, 2021, to October 8, 2021.
Serum 25-hydroxyvitamin D (25[OH]D) levels were measured and assessed for correlation with polysomnography metrics. Fasting blood samples were collected and vitamin D deficiency was defined as 25(OH)D level less than 20 ng/mL.
The consecutive sample included 72 patients (mean [SD] age, 6.7 [3.9] years; 34 [47.2%] females and 38 [52.8%] males). The mean (SD) AHI was 42.8 (25.5), and 35 participants (49.0%) had obesity. Vitamin D deficiency was present in 27 participants (37.5%). In univariate analysis, vitamin D deficiency was associated with younger age (difference, -5.0; 95% CI, -7.2 to -2.8), Black race (odds ratio [OR], 4.3; 95% CI, 1.4 to 14.3), female sex (OR, 4.8; 95% CI, 1.7 to 12.5), and higher obstructive AHI (difference, 13.8; 95% CI, 1.2 to 26.4). In multivariable analysis, vitamin D deficiency remained significantly associated with AHI. A 1.0-unit decrease in serum 25(OH)D levels was associated with an AHI increase of 0.7 (95% CI, 0.04 to 1.40).
The findings of this cross-sectional study indicate that vitamin D deficiency was common in children undergoing adenotonsillectomy for severe OSA and is significantly associated with increased OSA severity. Future research is needed on vitamin D supplementation and its association with any improvements in pediatric OSA treatment outcomes.
先前的研究已证明成人维生素D缺乏与阻塞性睡眠呼吸暂停（OSA）之间存在关联；然而，其与儿童OSA的关联正在显现。
评估维生素D水平与OSA儿童阻塞性呼吸暂停低通气指数（AHI）之间的关联。
设计、地点和参与者：这是一项对2至16岁患有严重阻塞性OSA（多导睡眠图检查时AHI≥20）的儿童进行的横断面研究，这些儿童于2017年至2022年在一家三级儿科耳鼻喉科诊所接受腺样体扁桃体切除术。分析中考虑了年龄、性别、种族、体重指数、哮喘病史和季节。数据于2021年9月3日至2021年10月8日进行分析。
测量血清25-羟基维生素D（25[OH]D）水平，并评估其与多导睡眠图指标的相关性。采集空腹血样，维生素D缺乏定义为25(OH)D水平低于20 ng/mL。
连续样本包括72例患者（平均[标准差]年龄，6.7[3.9]岁；34例[47.2%]为女性，38例[52.8%]为男性）。平均（标准差）AHI为42.8（25.5），35名参与者（49.0%）患有肥胖症。27名参与者（37.5%）存在维生素D缺乏。在单因素分析中，维生素D缺乏与年龄较小（差异，-5.0；95%置信区间，-7.2至-2.8）、黑人种族（优势比[OR]，4.3；95%置信区间，1.4至14.3）、女性（OR，4.8；95%置信区间，1.7至12.5）以及较高的阻塞性AHI（差异，13.8；95%置信区间，1.2至26.4）相关。在多变量分析中，维生素D缺乏仍与AHI显著相关。血清25(OH)D水平每降低1.0个单位，AHI增加0.7（95%置信区间，0.04至1.40）。
这项横断面研究的结果表明，在因严重OSA接受腺样体扁桃体切除术的儿童中，维生素D缺乏很常见，并且与OSA严重程度增加显著相关。未来需要对维生素D补充及其与儿童OSA治疗结果的任何改善之间的关联进行研究。
