Absence of blood pressure, metabolic, and inflammatory marker changes after adenotonsillectomy for sleep apnea in Greek children.
OBJECTIVE
Pediatric studies revealed associations of obstructive sleep-disordered breathing (SDB) with inflammation, metabolic dysfunction, and elevated blood pressure. Evidence about effects of adenotonsillectomy on these abnormalities is scarce. Aim of this investigation was to assess changes in C-reactive protein (CRP), circulating intercellular adhesion molecule-1 (cICAM-1), insulin and blood pressure levels after adenotonsillectomy for SDB in Greek children.


METHODS
Polysomnography was performed pre- and postoperatively in children with SDB and controls undergoing adenotonsillectomy for recurrent tonsillitis or otitis. Outcome measures were changes in serum markers and blood pressure.


RESULTS
Fifty-eight patients (6.2 +/- 2.5 years old) and 17 controls (6.5 +/- 2) were studied. After surgery, apnea-hypopnea index (AHI) decreased (mean: -5.9 episodes/hr; 95% confidence interval: -7.8 to -4) in patients. Patients and controls were similar regarding outcomes: CRP (-0.11 mg/dl [-0.25 to 0.02] vs. 0.13 [-0.19 to 0.46]; P = 0.11), cICAM-1 (-11.6 ng/ml [-38.6 to 15.4] vs. -46.6 [-101.7 to 8.6]; P = 0.23), insulin (2.49 mU/L [0.32-4.67] vs. -0.16 [-2.47 to 2.16]; P = 0.21), systolic blood pressure index (5.2% [2.1-8.3] vs. 10.8 [3.6-17.9]; P = 0.1) and diastolic blood pressure index (-3.2% [-7.2 to 0.8] vs. 2.8 [-5.5 to 11.2]; P = 0.16). Patients with CRP > 0.3 mg/dl had reduced values after AT (P = 0.003) and those with postoperative AHI < or = 1 had a decrease in diastolic blood pressure (P = 0.02).


CONCLUSIONS
Although adenotonsillectomy improves SDB, it has variable effects on inflammatory and metabolic markers or blood pressure.
Apostolidou
Maria T
MT
Department of Otorhinolaryngology, University of Thessaly School of Medicine, Larissa University Hospital, Larissa, Greece.
Alexopoulos
Emmanouel I
EI
Damani
Eleni
E
Liakos
Nikolaos
N
Chaidas
Konstantinos
K
Boultadakis
Evangelos
E
Apostolidis
Theoharis
T
Gourgoulianis
Konstantinos
K
Kaditis
Athanasios G
AG
D000233:Adenoidectomy; D015415:Biomarkers; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D005260:Female; D006115:Greece; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000517:prevention & control; D007328:Insulin / Q000097:blood*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D017286:Polysomnography; D011184:Postoperative Period; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome
D015415:Biomarkers; D007328:Insulin; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein