Plasma natriuretic peptides in children and adolescents with obstructive sleep apnea and their changes following intervention.
OBJECTIVE
This study aimed to evaluate circulating natriuretic peptides (NP) concentration in obese and non-obese children and adolescents with and without obstructive sleep apnea (OSA), and their levels following OSA treatment.


METHODS
Subjects with habitual snoring and symptoms suggestive of OSA were recruited. They underwent physical examination and overnight polysomnography (PSG). OSA was diagnosed if obstructive apnea-hypopnea index (OAHI) was ≥1/h. Fasting serum atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were taken after overnight PSG. The subjects were divided into obese, non-obese, with and without OSA groups for comparisons.


RESULTS
One hundred fourteen children (77 were boys) with a median [interquartile range (IQR)] age of 10.8 (8.3-12.7) years (range: 2.4-11.8 years) were recruited. Sixty-eight subjects were found to have OSA. NP levels did not differ between subjects with and without OSA in both obese and non-obese groups. Stepwise multiple linear regressions revealed that body mass index (BMI) z-score was the only independent factor associated with NP concentrations. Fifteen children with moderate-to-severe OSA (OAHI >5/h) underwent treatment and there were no significant changes in both ANP and BNP levels after intervention.


CONCLUSIONS
Body mass index rather than OSA was the main determinant of NP levels in school-aged children and adolescents.
Department of Paediatrics, The Chinese University of Hong Kong , Hong Kong , China.
Albert Martin
AM
Li
Department of Paediatrics, The Chinese University of Hong Kong , Hong Kong , China.
Chun Ting
CT
Au
Department of Paediatrics, The Chinese University of Hong Kong , Hong Kong , China.
Jodie Y
JY
Zhu
Department of Paediatrics, The Chinese University of Hong Kong , Hong Kong , China.
Kate Ching Ching
KC
Chan
Department of Chemical Pathology, The Chinese University of Hong Kong , Hong Kong , China.
Michael Ho Ming
MH
Chan
Department of Otorhinolaryngology - Head and Neck Surgery, The Chinese University of Hong Kong , Hong Kong , China.
Dennis Lip Yen
DL
Lee
Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong , Hong Kong , China.
Yun Kwok
YK
Wing
adenotonsillectomy; natriuretic peptides; obesity; obstructive sleep apnea