RESUMO
OBJECTIVE: Tonsillar hypertrophy cells appear to have an altered lipid metabolism as evidenced by modulated inflammatory cytokines that affect tissue lipid metabolism. The aim of this study was to investigate differences in tissue fat composition between obstructive sleep apnea (OSA) and recurrent infective tonsillitis (RT) in children. METHODS: Tonsillar tissues were collected from 114 patients with OSA and 92 patients with RT, aged 4-10 years, during tonsillectomy. The tissue lipid extracts were analyzed by gas liquid chromatography for a comprehensive fatty acid profile. RESULTS: In the tonsillitis tissue, the levels of palmitoleic acid (16:1n-7; P=0.002) and oleic acid (18:1n-9; P=0.003) were higher, and the level of stearic acid (18:0; P=0.004) was lower than that in the hyperplastic tonsillar tissue. Overall, tonsillar tissue of patients with RT had a significant increase in the total monounsaturated fatty acids (+9.9%; P<0.001) and the fatty acid desaturation index (+20.5%; P<0.001). Furthermore, oleic acid content of tonsillar tissue was positively correlated with BMI (r=0.20, P=0.004), snoring (r=0.16, P=0.022) and hypertrophy grade (r=0.18, P=0.023), which remain significant in the subgroup analysis by hypertrophy type. CONCLUSIONS: The change in the fatty acid composition may be regarded as an indicator of altered lipid metabolism occurring in vivo during human tonsillar hypertrophy, which might be linked to the severity or type of the tissue damage.
Assuntos
Ácidos Graxos/metabolismo , Apneia Obstrutiva do Sono/metabolismo , Tonsilite/metabolismo , Biomarcadores/metabolismo , Biópsia por Agulha , Estudos de Casos e Controles , Criança , Pré-Escolar , Cromatografia Líquida/métodos , Ácidos Graxos/análise , Ácidos Graxos Monoinsaturados/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Masculino , Ácido Oleico/metabolismo , Prognóstico , Estudos Prospectivos , Recidiva , Valores de Referência , Medição de Risco , Apneia Obstrutiva do Sono/patologia , Apneia Obstrutiva do Sono/cirurgia , Tonsilectomia/métodos , Tonsilite/patologia , Tonsilite/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: Phospholipase A2 (PLA2) plays a major part in growth regulation, differentiation and inflammation. It has been proposed as an evaluating marker for infection and inflammation. The aim of this study was to investigate activity of serum type II secretory PLA2 (sPLA2 IIa) in obstructive sleep apnea (OSA) and recurrent infective tonsillitis (RT) in children. METHODS: Activity of serum sPLA2 IIa was determined in children who underwent tonsillectomy, including OSA in 126 cases and RT in 60. Serum enzyme activities were measured using the standard assay with Diheptanoyl Thio-Phosphatidylcholin as substrate. RESULTS: The sPLA2 IIa activity of serum was significantly higher in RT than in OSA (P<0.01). Serum sPLA2 IIa activity in the RT patients was positively correlated with BMI (r=0.26; P=0.02), which was not apparent in OSA (r=0.14; P=0.09). CONCLUSION: This study suggests that serum sPLA2 IIa activity may be considered as a supportive diagnostic marker in suspected or clinically unclear cases of RT children.
