title: The evaluation of adenotonsillectomy on TNF-α and IL-6 levels in obese children with obstructive sleep apnea.
abstract: OBJECTIVE
  (1) To evaluate the effect of adenotonsillectomy (T&A) on clinical signs in obese children with obstructive sleep apnea (OSA); (2) to evaluate the changes in tumor necrosis factor-α (TNF-α) and interleukin (IL)-6 levels pre- and post-surgery; and (3) to determine a potential explanation for changes in cytokine levels after T&A therapy.
  
  
  METHODS
  In brief, 90 obese children with OSA were enrolled. Polysomnographic data, such as an apnea-hypopnea index (AHI) and oxyhemoglobin saturation (SaO₂), and demographic information, such as body mass index (BMI), were collected. TNF-α and IL-6 levels were determined before and 6 months after T&A treatment.
  
  
  RESULTS
  It was observed that 61.1% of obese children with OSA were persistent after T&A therapy. In general, AHI (events/h) measures decreased from 22.26 ± 9.141 to 8.88 ± 5.909 before and after a 6-month follow-up period, respectively, and nadir SaO₂ (%) levels increased from 74.26 ± 7.486 to 86.37 ± 5.578 pre- and post-surgery, respectively. However, no discernible differences in BMI measures before and after a 6-month follow-up period (40.996 ± 5.2486 vs. 40.597 ± 5.0540) were observed. No significant differences in the TNF-α and IL-6 levels pre- and post-surgery were observed. TNF-α and IL-6 plasma levels were highly correlated with BMI measurements (TNF-α: r(2)=0.2350, P<0.001; IL-6: r(2)=0.6629, P<0.001). In contrast, there was no association between plasma levels and AHI measures (TNF-α: r(2)=0.03377, P=0.0829; IL-6: r(2)=0.03946, P=0.0605).
  
  
  CONCLUSIONS
  T&A therapy can improve clinical symptoms and signs but is not a cure for the treatment of obese children with OSA. The inflammation levels of TNF-α and IL-6 changed little. To reduce the risk for excessive daytime sleepiness, supplementary therapies should be introduced for OSA.
authors.affiliation: Department of Clinical Laboratory Center, Chongqing Health Center for Women and Children, Chongqing 400013, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Chu
authors.forename: Qiuhong
authors.initials: Q
authors.lastname: Li
mesh_terms: D000233:Adenoidectomy; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D009765:Obesity / Q000150:complications*; D017286:Polysomnography; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications* / Q000601:surgery*; D014068:Tonsillectomy; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha