title: Inflammatory markers and obstructive sleep apnea in obese children: the NANOS study.
abstract: BACKGROUND
  Obesity and obstructive sleep apnea syndrome (OSA) are common coexisting conditions associated with a chronic low-grade inflammatory state underlying some of the cognitive, metabolic, and cardiovascular morbidities.
  
  
  OBJECTIVE
  To examine the levels of inflammatory markers in obese community-dwelling children with OSA, as compared to no-OSA, and their association with clinical and polysomnographic (PSG) variables. Methods. In this cross-sectional, prospective multicenter study, healthy obese Spanish children (ages 4-15 years) were randomly selected and underwent nocturnal PSG followed by a morning fasting blood draw. Plasma samples were assayed for multiple inflammatory markers.
  
  
  RESULTS
  204 children were enrolled in the study; 75 had OSA, defined by an obstructive respiratory disturbance index (RDI) of 3 events/hour total sleep time (TST). BMI, gender, and age were similar in OSA and no-OSA children. Monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in OSA children, with interleukin-6 concentrations being higher in moderate-severe OSA (i.e., AHI > 5/hrTST; P < 0.01), while MCP-1 levels were associated with more prolonged nocturnal hypercapnia (P < 0.001).
  
  
  CONCLUSIONS
  IL-6, MCP-1, and PAI-1 are altered in the context of OSA among community-based obese children further reinforcing the proinflammatory effects of sleep disorders such as OSA. This trial is registered with ClinicalTrials.gov NCT01322763.
authors.affiliation: Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, 5721 S. Maryland Avenue, Chicago, IL 60637, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Gileles-Hillel
authors.affiliation: Sleep Unit, Instituto Carlos III.CIBERES, Spain ; CIBER of Respiratory Diseases, Instituto Carlos III.CIBERES, Spain ; Hospital Universitario de Burgos (HUBU), Burgos, Spain.
authors.forename: María Luz
authors.initials: ML
authors.lastname: Alonso-Álvarez
authors.affiliation: Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, 5721 S. Maryland Avenue, Chicago, IL 60637, USA.
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
authors.affiliation: Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, 5721 S. Maryland Avenue, Chicago, IL 60637, USA.
authors.forename: Eduard
authors.initials: E
authors.lastname: Peris
authors.affiliation: Sleep Unit, Instituto Carlos III.CIBERES, Spain ; CIBER of Respiratory Diseases, Instituto Carlos III.CIBERES, Spain ; Hospital Universitario de Burgos (HUBU), Burgos, Spain.
authors.forename: José Aurelio
authors.initials: JA
authors.lastname: Cordero-Guevara
authors.affiliation: Sleep Unit, Instituto Carlos III.CIBERES, Spain ; CIBER of Respiratory Diseases, Instituto Carlos III.CIBERES, Spain ; Hospital Universitario de Burgos (HUBU), Burgos, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Terán-Santos
authors.affiliation: Sleep Unit, Instituto Carlos III.CIBERES, Spain ; Hospital Universitario Valdecilla, Santander, Spain.
authors.forename: Mónica Gonzalez
authors.initials: MG
authors.lastname: Martinez
authors.affiliation: Sleep Unit, Instituto Carlos III.CIBERES, Spain ; CIBER of Respiratory Diseases, Instituto Carlos III.CIBERES, Spain ; Hospital Val d'Hebron, Barcelona, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Jurado-Luque
authors.affiliation: Sleep Unit, Instituto Carlos III.CIBERES, Spain ; CIBER of Respiratory Diseases, Instituto Carlos III.CIBERES, Spain ; Hospital San Pedro de Alcantara, Caceres, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Corral-Peñafiel
authors.affiliation: Sleep Unit, Instituto Carlos III.CIBERES, Spain ; CIBER of Respiratory Diseases, Instituto Carlos III.CIBERES, Spain ; Servicio de Investigación, Hospital Universitario Araba (BioAraba), Universidad del País Vasco (UPV/EHU), Vitoria, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Duran-Cantolla
authors.affiliation: Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, 5721 S. Maryland Avenue, Chicago, IL 60637, USA.
authors.forename: David
authors.initials: D
authors.lastname: Gozal
mesh_terms: D000293:Adolescent; D000818:Animals; D018932:Chemokine CCL2 / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood* / Q000503:physiopathology*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000503:physiopathology*
chemical_list: D018932:Chemokine CCL2; D015850:Interleukin-6; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human