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J Pediatr ; 239: 168-174, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34450122

RESUMEN

OBJECTIVE: To evaluate structural and functional carotid changes and inflammatory profiles in children with obstructive sleep apnea (OSA) and healthy controls. STUDY DESIGN: Patients with OSA and matched controls (ages 5-13 years) were recruited. Proinflammatory cytokines and acute phase reactants were measured at 6:00 p.m. Common carotid artery measures were determined using ultrasound. Confirmatory factor analysis was used to determine subgroups of cytokines and their effects on carotid measures. RESULTS: Ninety-six patients participated (53 healthy controls, 43 patients with OSA). OSA was associated with increased proinflammatory cytokines (cluster of differentiation-40 ligand [CD40-L], interleukin [IL]-6, and IL-8) and high sensitivity C-reactive protein (P < .05 for all). One cytokine subgroup (IL-6 and IL-8) was negatively associated with markers of carotid function, indicating reduced arterial distensibility and increased stiffness (P < .05 for 3 ultrasound measures); and tumor necrosis factor-α had an opposing effect on carotid function compared with this cytokine subgroup (P < .05 for 2 ultrasound measures). Linear regression demonstrated significant associations between and tumor necrosis factor- α and 2 measures of carotid function (P < .05 for each). Children with OSA did not have functional or structural carotid changes compared with controls. CONCLUSION: OSA was not directly associated with structural and functional carotid changes but was associated with upregulation of key proinflammatory cytokines (sCD40-L, IL-6, and IL-8). Together, IL-6 and IL-8 were associated with changes in carotid function. Longitudinal studies are needed to demonstrate that the inflammatory milieu observed in our population is a precursor of atherosclerosis in children.


Asunto(s)
Proteínas de Fase Aguda/metabolismo , Aterosclerosis/etiología , Arteria Carótida Común/fisiopatología , Citocinas/sangre , Inflamación/etiología , Apnea Obstructiva del Sueño/fisiopatología , Adolescente , Aterosclerosis/sangre , Aterosclerosis/diagnóstico , Aterosclerosis/fisiopatología , Biomarcadores/sangre , Arteria Carótida Común/diagnóstico por imagen , Arteria Carótida Común/patología , Estudios de Casos y Controles , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Inflamación/sangre , Inflamación/diagnóstico , Inflamación/fisiopatología , Modelos Lineales , Masculino , Estudios Prospectivos , Apnea Obstructiva del Sueño/sangre , Apnea Obstructiva del Sueño/complicaciones , Ultrasonografía
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