title: Effect of adenotonsillectomy on endothelin-1 and C-reactive protein levels in children with sleep-disordered breathing.
abstract: OBJECTIVE
  This study aimed to evaluate the influence of adenotonsillectomy on the plasma concentration of endothelin-1 (ET-1) and C-reactive protein (CRP) in children with sleep-disordered breathing (SDB). The relationship between quality of life and ET-1 levels was also evaluated.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Before-and-after case series.
  
  
  METHODS
  Fasting blood samples for ET-1 and high-sensitivity CRP were drawn preoperatively in all patients and at 3 to 4 months postoperatively. The Obstructive Sleep Apnea-18 (OSA-18) survey and Brouilette symptom score were completed by each child's parents during the same time periods.
  
  
  RESULTS
  The mean ET-1 level decreased from 3.51 ± 0.93 fmol/mL to 2.67 ± 0.69 fmol/mL postoperatively (P < .01). OSA-18 survey scores and Brouilette symptom scores also decreased in the postoperative period (P < .01). When comparing moderate and severe cases to mild cases according to Brouilette scores, ET-1 levels were significantly higher in moderate and severe cases (P < .01). There was a significant correlation between ET-1 and the OSA-18 survey scale (r = 0.442; P = .001). Although CRP levels decreased from 0.63 ± 1.19 mg/dL to 0.31 ± 0.23 mg/dL postoperatively, this was not statistically significant.
  
  
  CONCLUSIONS
  Adenotonsillectomy effectively lowered plasma ET-1 levels in children with SDB and thus may have reduced their related risk for cardiovascular disease. In addition, adenotonsillectomy improved quality of life in this group.
authors.affiliation: Haydarpasa Numune Education and Research Hospital, 1st ENT Clinic, Uskudar, Istanbul, Turkey. arzutatli@yahoo.com
authors.forename: Arzu
authors.initials: A
authors.lastname: Tatlipinar
authors.forename: Burak
authors.initials: B
authors.lastname: Cimen
authors.forename: Dursun
authors.initials: D
authors.lastname: Duman
authors.forename: Erkan
authors.initials: E
authors.lastname: Esen
authors.forename: Sema
authors.initials: S
authors.lastname: Köksal
authors.forename: Tanju
authors.initials: T
authors.lastname: Gökçeer
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019332:Endothelin-1 / Q000032:analysis / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017286:Polysomnography; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011788:Quality of Life; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000097:blood* / Q000175:diagnosis; D018709:Statistics, Nonparametric; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019332:Endothelin-1; D002097:C-Reactive Protein